6^ The Origin M '^Jreatmenj OF TAMMERING GEORGE ANDREW LEWIS C0mil6HT£B /f4 k^ -t^ cy "iTdaJ. GEORGE ANDREW LEWIS, Founder of The Lewis Phono-Metric Method, Principal of The Lewis School for Stammerers^ Editor of the " Phono-Meter," Author of "The Practical Treatment of Stammering and Stuttering." THE ORIGIN AND TREATMENT OF STAMMERING {Seventh Edition Enlarged and Revised.) BY £,^ GEO. ANDREW LEWIS (An laveterate Stammerer for more than twenty years.) FOUNDER OF THE LEWIS PHONO-METRIC METHOD Registered at patent offices in the United States and Canada. FOR THE PERMANENT CURE OF STAMMERING AND STUTTERING AND ALL OTHER FORMS OF IMPERFECT UT- TERANCE OF SPEECH AND ARTICULATION A practical and scientific treatise on the Cause and Treatment of Speech Defects with original illustrations showing the difference between mild and severe types of stammering. Lectures delivered before Elocutionists' Conventions and Medical Societies with suggestions for treatment. THE EXPERIENCE OF THE AUTHOR AND ENDORSEMENT OF THE PUBLIC COPYRIGHTED BY GEO. ANDREW LEWIS 1903 {All rights reserved.) or/ C ^' DETROIT: PHONO-METER PRESS, ~^^/brak3 CONTENTS PAGE Geo. Andrew Lewis Frontispiece Author's Experience 5 Anatomical View of the Speaking Organs - - - 12 The Origin of Stammering 13 Curable and Incurable Forms of Stammering - - 33 Child Stammering --- 52 Diagnosis and Treatment of Obstinate Cases of Stam- mering 63 Helpful Hints and Exercises - 88 Stammering — Practically, Theoretically - - - 99 Cause and Cure of Speech Defects - - - - 104 Institutional and Home Treatment - - - - 112 The Mechanism of Speech 134 Relations of the Body and Mind tO Stammering - - 146 Peculiarities in Stammering and How to Overcome Them 160 Suggestions for Stammerers 175 THE AUTHOR'S EXPERIENCE "Come, I will show thee an affliction Unnumbered among the world's sorrows." — Tupper. The earliest recollection of my difficulty carries me back to my infancy. I can well remember my mother taking me to school for the first time, and, with tearful eyes, she told the teacher not to chastise me if I stam- mered, because, said she, *• He cannot help it." From that time until my cure, I cannot remember a period in my whole life when I did not labor to much disadvan- tage because of my impediment or when I could have said, " I can speak." True, at times I could speak, but always with a mental strain, and there were many times when I was almost dumb. The severity of my trouble was heightened by the fact that some of my relatives were similarly afflicted, or, in other words, I had inherited my difficulty, which made a cure, in my mind, all the more improbable. In this supposition I have since found I was correct. The organism being predisposed to the development of stammering the defect was planted in the prenatal life, and, therefore, had the force of the unnatural condition as a part of the condition of its own ex- istence. Several months after my mother had taken me to school she passed away to a better world, after which time, notwithstanding my father and family tried every available means to lessen the severity of my trouble, I gradually grew worsp^ ^j^jT^"^^g-^^^ed to break me off by offers of mon^yril^ could or Woi^^S;epeat after him -Mjrr THE ORIGIN AND TREATMENT OF STAMMERING words and sentences he would speak, — in vain. My difficulty was rapidly developing into the most severe form of stuttering, a condition where, in my effort to speak, I placed the stress to articulate upon the wrong muscles, thereby causing the rapid repetition of a word or syllable before the following word or syllable could be uttered. ^. ""This is the kind of stuttering that many persons mock at and mimic, many of whom have had cast upon their shoulders by Almighty God the weight that they would burden down with ridicule and jest for the poor unfortunate who carries it around. A young man who applied for admission to my Institute told me he had acquired his difficulty by imitation, and not- withstanding the fact that he was of well-to-do pa- rents, who had paid out almost a fortune in their efforts to find relief for him, he said his life had been a blank, the direct result of his own folly and jest. Let those who mock be careful. Surely the poor stammerer has enough to suffer without bearing the taunts and ridicule of the public. As I grew older I naturally became more sensitive about my difficulty. My friends and relatives experi- enced and expressed great sorrow over my condition, which only made me suffer the more, because I knew that those who loved me, and whom I loved, suffered with me. Should I, by chance, be invited out of an evening to a reception or party, I would many times imagine it was for the purpose of exhibiting my affliction, which —6— THE ORIGIN AND TREATMENT OF STAMMERING now began to be accompanied by contortions, lolling the tongue, gasping for breath, and drawing the mus- cles. If not for the purpose of exhibiting my infirmity, then why was I asked ? Certainly not because of my entertaining faculties, nor for my conversational abili- ties, and as many persons whom I knew held me up to mockery behind my back, and invariably avoided con- versation with me except by compulsion, I felt that I was almost alone in the world. True, many persons were kind to me, and thought- ful, considerate people spoke many kind words of hope and comfort to me. These were a few oi the streaks of sunshine that stole into my life, and it is unnecessary for me to say that those persons — may God bless them wherever they are — shall never be forgotten. Between the age of nineteen and twenty, my diffi- culty began to change. That rapid repetition of words ceased. The outward manifestation of my trouble left me for a time, but the inward torture I endured was sometimes awful. My impediment was speedily grow- ing worse. In my effort to conceal my affliction, I rapidly developed the jnejatal^j^hase of a most severe type of stammering and added new horrors to my al- ready woeful life. I became almost tongue-tied — dumb as it were ; instead of rapidly repeating mysylla- bles I now stood transfixed, my mouth distended like a funnel, my limbs slowly drawing themselves into un- gainly shapes, my eyes assuming the meanwhile a glassy appearance. When I had labored in this condition for several moments, overcome by exertion and extreme effort, my nerves all unstrung, I would, as by lightning -7- THE ORIGIN AND TREATMENT OF STAMMERING impulse, sink back, gasp for more breath and try again with the same results. I shall never forget the evening I returned home from school, disgusted. Throwing my books in the corner, I vowed and resolved I would never return. What was I to do ? My father had not wealth, and I must soon be cast adrift to shift for myself and fight my own battles with the world. Reader, are you a stammerer? Are you a stut- terer? Have you ever suffered the impatience and ridicule of cruel and unsympathetic people? Those are the moments when we either grow despondent or desperate, according to our individual nature and tem- perament. I decided to follow the mechanical arts, and ap- plied myself diligently to the study'of mechanics. My skill was soon acknowledged, and, with the offer of a fair salary, I left home the following year, resolved, if travel would reveal to me a balm for my wound, I would endeavor to be healed. Much advice was given me, and many pet theories and methods of cure urged, a few of which I give herewith — Hold a quill between the teeth; keep a pebble under the tongue; whistle just before uttering a word ; take a long breath ; move the head from side to side, and many such worthless and nonsensical ideas. For several years I continued to follow my busi- ness, saving money in the meantime to enable me to visit the East, where I understood some satisfactory results in cures had been achieved. The mental strain I had suffered and the loss of vitality in consequence THE ORIGIN AND TREATMENT OF STAMMERING were rapidly making me a mental and physical wreck. At last I resolved to go and investigate, and resigned my position at Bay City, Michigan, for that purpose. I visited the best schools on the continent, obtaining some relief at an enormous expenditure of time and money. After hard and diligent application, I used up my surplus capital, and was necessarily forced to seek em- ployment. The rehef I had obtained proved but tem- porary, for occasionally my old trouble would crop up with all its horrors, notwithstanding I continued my exercises regularly, although I did not begrudge the amount of time and money I had spent, as I felt I was now on the trail and would soon hunt down my antago- nist. About this time I was offered, and accepted, a posi- tion with I. Herzberg & Bros., wholesale and retail manufacturing jewelers, S. E. corner lOth and Chestnut streets, Philadelphia, Pa. As this store was one of the best appointed of its kind, in the most fashionable business center of the city, I felt that if I could succeed in entirely overcoming my impediment of speech I would be of more value to them, as well as realizing within myself my fondest dreams and aspirations. Could not a method or a means of cure be devised or invented that would entirely and permanently eradicate every trace of stammering ? Surely there could, and if so how many others like myself, who had obtained but partial relief, could be set at liberty ? How many oth- ers, being dragged back as by some invisible monster, whose claws sank deeper and deeper day by day, would thus be enabled to escape ? — 9 — THE ORIGIN AND TREATMENT OF STAMMERING The result of my experiment and investigation proved more than I had expected. In the remarkably short period of ten days I found that I had not only succeeded in entirely eradicating every vestige of my former difficulty, but had also evolved a method of cure that must sooner or later crown with new hope the sor- rowful lives of many disheartened stammerers. A new ambition seemed to cast its shadows upon me. I had, by combining the application of my sys-. tem with the knowledge I had gained in the best schools on this continent for the correction of speech impedi- /ments and cultivation of the voice, secured a method for the cure of stammering ioMwdi^A upon an educational basis ; a method for the cure of stammering founded upon the scientific, psychological and physiological laws that underlie and govern the art of perfect speech ; a method for the cure of stammering that consists in go- ing back to fundamental principles and building up the speech through a course of training founded on a scien- tific, educational basis; a method for the cure of stam- mering where the pupil not only learns how to speak properly and perfectly, but also to govern and control the will power in connection with the production oA per- 'fect speech which relates to the higher nerve centers affected as well as the control of the speaking organs. This means of cure. The Lewis Phono-Metric Method, has the support of not only the best business and pro- fessional men in the country, but is also endorsed in the highest terms by well-known schools of elocution and voice culture and by other institutions for the cure of speech impediments. — 10 — THE ORIGIN AND TREATMENT OF STAMMERING There is no doubt that stammering Is a more seri- ous trouble than is generally believed, and although the stammerer in the past has to a large extent been obliged to bear with humiliation the brunt of his afflic- tion, public sympathy is rapidly assuming the place of public ridicule, and the time is not far distant when the cause of the stammerer will appeal to the masses in the same sense as the cause of other human infirmities and demand the recognition it deserves. The blighted lives, the crushed ambitions, the wail of parents in behalf of their children, the tears, the letters of despond- ency, supplications for help from every quarter of the civilized globe, together with the nervous and physical wrecks that stammering has left in its wake, combine to prove the extent of the stammerer's helpless condition. I know of no other work in which I could engage to better prove my usefulness to mankind than that of treating the stammerer. Having myself for more than twenty years been obliged to bear the yoke, I can bet- ter appreciate the suffering and sorrow of others thus unfortunately afflicted. With the aim of devoting my entire future life for the benefit of others I have founded my Institution on a basis of Home and School Combined hitherto unapproached, and hope by the continued encourage- ment of success to extend to hundreds of suffering and disheartened stammerers a new life, crowned with new ambitions. One of God's greatest and most noble blessings is the privilege and enjoyment of perfect and unfettered speech. Very sincerely, Geo. Andrew Lev^is. THE ORIGIN AND TREATMENT OF STAMMERING ANATOMICAL VIEW OF THE SPEAKING ORGANS I, canal from throat to middle ear ; 2, back part of nose ; 3, soft palate ; 4, soft palate covering tonsil; 5, tonsil; 6, base of tongue; 7, epiglottis; 8, part of cartilage of larynx; 9, laryngeal portion of pharynx; 10 cavity of larynx ; 11, nasal fossae ; 12, vault of the palate, or roof of mouth ; 13, 14. tongue : 15, muscle beneath tongue ; 16, hyoid bone ; 17, interior of larynx 18, 19, tnyroid cartilage. THE ORIGIN OF STAMMERING BY Geo. Andrew Lewis I^ecture delivered by invitation before the members of the Wayne County Medical Society, February 20, 1896, at the office and parlors of Dr. John E. Clark, President of the Board of Education, Detroit, Mich. Probably no class of unfortunates seeking relief for an affliction has received so little benefit as the stam- merer. So much that is erroneous and contradictory has been written and said about stammering and its cure, that persons thus afflicted have become greatly confused, and many who have given much time and study to the subject know not what to think. The injurious modes of treatment resorted to by surgeons during the early part of the present century, together with the thousand-and-one, or more, useless theories that have since been advanced for the cure of this difficulty by as many charlatans and humbugs, have probably served only to make the stammerer the more discouraged and have crushed his hopes of ever obtain- ing positive relief or permanent cure. I shall not attempt to go into detail and describe the many nonsensical ideas that stammerers from time to -13- THE ORIGIN AND TREATMENT OF STAMMERING time have had imposed upon them by the countless number of "professors," whose dupes they have been and to whom some of them have paid large sums of money. Many of these persons have applied to us for treatment, after having been thus victimized, and have related to us their former experiences. One stated that he had been treated by correspondence and that he had been obliged to pay in advance for each letter of in- struction. Another had paid a large sum of money for a badly mutilated tongue. A third had been told, as a great secret by a traveling '* professor" (for which he had paid well), to wash his throat out every night with a gargle of salt and water and sleep with a pebble underneath his tongue. We have his statement for it that he continued to do this with faithful regularity for more than two years, A fourth told us that he had been under the treatment of an advertising physician, and produced as evidence a bundle of prescriptions. A fifth had worn an electrical band around his waist, to which were attached wires connecting with a pocket battery. A sixth had unluckily fallen into the hands of a hypnotist, who guaranteed to cure him in a half hour. A seventh had been placed under a heavy- penalty of revealing the secret, and told if she would move her head backwards and forwards every time she attempted to speak she would in this manner open the glottis and the result would be a perfect and continuous flow of speech. I could go on in this manner and fill a whole vol- ume with the experiences of hundreds of stammerers who have been thus defrauded and victimized by these THE ORIGIN AND TREATMENT OF STAMMERING charlatans, from many of whom they received not one particle of benefit, although their experience cost them, in many instances, an expenditure of a great deal of time and money. In fact, I have arrived at the con- clusion that persons thus victimized are made worse than they were before their contemplation of treatment. Thus, for years and years, have been practiced differ- ent modes and methods for the cure of this distressing malady, the unfortunate sufferer finding out too late that he had been the victim of some dishonest quack, willing to take his money from him regardless of the benefit which he (the stammerer) should derive from the experience. Scarcely a day passes that we do not receive one or more letters giving a full and detailed account of former experiences through which stammerers thus victimized have passed. Many of our correspondents who have undergone one or more of such treatments without suc- cess express grave doubts as to a permanent cure. We never urge or offer inducements to such persons to undergo treatment, but rest the matter entirely with themselves. If our recommendations prove insufficient to convince them of the merits of our system, we furnish them with the names of a great number of persons who have attended our Institute or who know of the success of our work, and ask them to write to any or all, if they so desire, and ask an honest opinion concerning the re- liability of our treatment. I would dwell longer on this cause of distrust did I not believe that enough has already been said. Professor Herman Klencke, M. D., of Hanover, who — 15 — THE ORIGIN AND TREATMENT OF STAMMERING conducted a school for the cure of stammering as early as 1840, and who was probably one of the first to de- nounce as quackery surgical operations and advance radical ideas for the treatment of stammering, very cleverly draws the following comparison — *' Many phy- sicians and 'stutter doctors' treat this disorder whose seat and cause they know nothing about. The proce- dure seems to me," continues Dr. Klencke, " like that of a person who would attempt to catch up with the bright spot which some one throws in his way by the reflec- tion of the sun on a mirror, and who would strive to tread out the spot or cover it up with his hands." Before entering into a discussion of the origin of stammering let us first consider the following definitions : Aristotle defined stammering as the inability to ar- ticulate a certain letter, and stuttering as the inability to join one syllable with another. Mr. Potter, one of the latest, defines stammering, as commonly used, as *' a temporary inability to articulate, the organs being tightly held together; stuttering, as the repeated utterance of one sound before the next can be uttered, both resulting from an inability of the will to control the organs of speech properly, and a defi- ciency of a ready response to the will by the organs themselves." Again we read — " Stammering, the inabiHty to pro- duce certain sounds, or the substitution of one sound for another." I quote from another authority, ** Stammering is the result of a functional disorder of that portion of the brain which presides over the faculty of speech." — 16 — THE ORIGIN AND TREATMENT OF STAMMERING A number of English and American writers use the terms stuttering and stammering synonymously. Dr. Klencke draws the parallel as follows : STUTTERING ist. The Stutterer immediately be- gins to stutter violently when he is observed, and shows a spasmodic fear and apprehension. 2d. He does not betray his defect in slow, measured declamation or in singing, or when talking in syllabic measure. 3d. He exhibits an agitation of his respiratory organs and conges- tion of the blood in the chest and head, which is increased in propor- tion to his efforts to overcome his difl&culty, and there appears a con- vulsive action of the chest, throat, and head. 4th, He can correctly form all con- sonants as separate sounds, without a loud tone or in a whisper, but be- gins at once to stutter if he attempts to join certain sounds with the voice or with a vowel. His voice evidently fails by the wrong action of the mechanism of the muscles, respira- tion, and voice function. STAMMERING ist. The Stammerer usually speaks better when he is observed and thus forced to pay attention to him- self, and only under peculiar circum- stances does he show fear and appre- hension. 2d. He betrays his defect when careless, in singing, declamation, and measured talking. 3d. He never exhibits an agitation of his respiratory and blood circu- lating organs, neither nervous nor convulsive action, and by action of his will he can partly or wholly over- come his defect. 4th. He does not have the least difl&culty in the formation of his voice. He betrays his defect as much in loud talking as in whispering, and the combination of his defective sounds with the vowel meets with hindrance. In addition to the above, Dr. Klencke also gives the following: *' Stuttering is a defect which is mani- fest only in talking and not in singing or declaiming. Its causes lie in the auxiliary organs of speech in the organs of respiration and vocalization, without the artic- ulating organs being primarily affected. [7 — THE ORIGIN AND TREATMENT OF STAMMERING " Stammering, on the contrary, is a defect which is manifest the same in singing and declaiming as in talk- ing. Its causes lie in the organs between the larynx and the lips, in the articulating organs." Prof. A. Kussmaul, of Strassburg, says, in Ziems- sen's Cyclopedia of the Practice of Medicine, Vol. 14, page 633, "Stammering consists in the incapacity to pronounce the letters properly, while in stuttering there is temporarily a spasmodic inability to vocalize certain sounds, especially the explosive consonants." The above definitions are but a few of a great number we have been given at different times by differ- ent authorities. In fact, such a great number of the- ories have been advanced, probably for the reason that scarcely two persons experience this difficulty in exactly the same manner or under the same conditions, that the stammerer has been compelled to accept a con- glomeration of ideas, concerning the real nature of his malady, and grope his way in the dark in his effort to free himself from his unfortunate affliction. Stammering has been confounded with stuttering and vice versUy in consequence of which a multitude of entirely dissimilar conditions of abnormal speech have been heaped together and designated either stammer- ing or stuttering, a general cure applied, which, in a few cases proved successful. The entanglement became still more increased when the ignorance with regard to stuttering, under which term at one time all other defects of speech were included, stimulated the surgical craze to search for local causes. In conse- quence of this entanglement of ideas concerning the — 18 — THE ORIGIN AND TREATMENT OF STAMMERING real causes and conditions of stammering there sprang forth as many ideas setting forth numerous methods of treatment. I do not wish to infer that all per- sons thus interested were impostors, but would rather attribute the mistakes of many of them to ignorance of the true origin of the difficulty. While many errors were thus being made, much good was being accom- pHshed, although the stammerer's tongue oftentimes suffered mutilation and untold misery for crimes of which it was not guilty. The continued investigation on the part of eminent scientists and physicians in search for an infallible method of cure brought forth advanced ideas, which sooner or later must abolish the crude theories of early investigators. To the painstaking efforts of a few who gave almost their entire lives to the study of this neglected subject are we indebted for the fundamental principles from which modern methods of treatment have evolved. When I say modern methods of treatment I do not refer to the many schemes and trickeries that have been imposed upon the stammerer by charlatans or pretentious ** professors," some of whom knew not the first principle of the correct basis for voice or tone pro- duction, and a few of whom have amassed ill-gained fortunes from the unfortunates who were unlucky enough to fall into their clutches. I refer to the meth- ods of treatment and of business dealing entertained by a few conscientious and practical workers, who are endeavoring in behalf of the stammerer to not only crush out the trickery and deception of these undeserv^ — 19 THE ORIGIN AND TREATMENT OF STAMMERING ing persons and bury the crude practices of surgery, but who are striving to give to their fellow men a prac- tical and thorough means of eradication for an affliction that is probably one of the most severe, certainly one of the most neglected, of all human ailments. Concluding my remarks concerning the difference between the definitions of the terms "stammering" and "stuttering" I give herewith the concensus of opinion of the best authorities of modern times in this country and Europe, supported by my own personal experience as a sufferer from a most severe type of stammering for more than twenty years : — Stammering. The inability, under certain con- ditions, to articulate, or control the organs of speech, which are usually, under such circumstances, tightly held together, accompanied in many cases, by the sub- stitution of one sound for another. Stuttering. A defect in respiration and vocal- ization, oftentimes causing spasmodic action or the rapid repetition of one word or syllable before the fol- lowing one can be uttered. The former is due to a deficiency or lack of exer- cise and control of mental energy of the will over the organs of utterance, and is usually accompanied by contorting the features, rolling the eyes, or drawing the limbs. The latter, due to an improper manner of breathing and vocalization, is usually accompanied by spasmodic actions of not only the speaking organs, but oftentimes the whole body becomes violently convulsed and contorted. THE ORIGIN AND TREATMENT OF STAMMERING Having thus considered the definitions of stammer- ing and stuttering, let us now enter into and discuss the real origin or primary cause of this difficulty. If you will follow me closely I will endeavor to carry you with me through a practical and scientific investigation, and locate, if possible, the real source and origin of stammer- ing. I shall confine my statements wholly to my own practical views on the subject, gathered from years of careful study of recognized authorities and from contact with many persons thus afflicted, both before and since my cure. We have already determined that stammering is an impediment of the speech. Let us consider. What is speech ? Tupper has very appropriately said, " Speech is the golden harvest that followeth the flowering of thought." Speech may also be considered a means of convey- ance. I might quote many definitions for this term, but do not think it necessary. It conveys to us by the most direct means the thoughts of men, and is probably the most important instrument God has given to us. Let us then trace it to its origin, and, by breaking it up into different elements, analyze it to discover, if possible, the original cause of the stammerer's difficulty. FIRST Ideas are received, arising either from immediate sensations, or originating in the brain in an abstract manner, and are arranged in proper succession by that organ. THE ORIGIN AND TREATMENT OF STAMMERING SECOND The will determines to give this train of ideas ex- pression in any way it can. So far, the process of action can be called only mental. THIRD The stimulation to action of the motive nervous system connected with the speaking organs. FOURTH The motive nervous system thus stimulated, gener- ates to action the vocal apparatus, resulting in articulate speech. Each step is, of course, tributary to the preceding one and as long as all act in harmony, one with another, fluent speech and perfect articulation are the result. The question now arises — where in this chain do we find the deficiency that manifests itself in the stam- merer? Let us go back and discuss the first element considered. To argue that the elaboration of thought in the brain of the stammerer is deficient and its arrangement for production unsystematic is to argue that the stammerer, intellectually speaking, is not only weak-minded, but also lacking of intelligence. Do we find this to be the case? The fact that many of the brightest and brainest men of ancient and modern times have suffered from stammering is conclusive evidence that stammering is THE ORIGIN AND TREATMENT OF STAMMERING not due at least to any lack of intellectual power on the part of the person thus afflicted. History tells us of many notable persons who have stammered. It is announced that Louis II. of France and Michael II. were both surnamed Le Begue, meaning stammerer. Louis XIII. of France was also a stam- merer. The Rev. Canon Kingsley was a stam- merer. Charles Lamb was a stutterer, and the notable physicians, Viosin, Palmer, Chegoin, Merkel, Guil- laume, D'Alais, Bacquerel, and Cohen were all stam- merers, -^sop, Virgil, and Demosthenes were likewise afflicted. Mrs. Inchbold, the famous English actress, was another who triumphed over a difflculty of speech. Mahomet-el-Rasser, King of Spain; Eric, King of Sweden; Admiral Annebant; Tahtaglia, the ItaHan engineer ; Bossy d' Anglas, the painter ; Daird ; the critic Hoffman ; Camille Desmoulins, celebrated French revolutionist and journalist, and Martin F. Tupper, the celebrated English poet, all suffered from stammering, as did also the Hon. Wm. A. Graham, United States Senator ^ and Governor of North Carolina in 1850. Allusions to this disorder are found also in the Bible. Moses was a notable example. The Ephraimites, and those whom Jesus cured of their impediments of speech. Having thoroughly satisfied ourselves that the defect is not manifest in the first element of speech, let us proceed to and consider the second. — The will determines to give this train of ideas expression in any way it can. — Is the desire to give utterance by physical act to internal thought in any way necessarily lacking — 23 — THE ORIGIN AND TREATMENT OF STAMMERING in the stammerer originally? If so, the defect must arise from either excessive or deficient energy or desire, in which case we would find that the stammerer, dur- ing infancy, before speech is complete, would be wholly unable to cry. It uses this means of making known its wants, and if the defect originated from a deficient or excessive mental desire, we would find this child, when it attempted to make known its wants, would not only be wholly unable to do so, but would, through its efforts, betray all the symptoms of a stammerer. We usually find, however, that the stammerer as a child does not betray the symptoms of his affliction. It is not until a more complex action is thrown upon his motive powers that his defect is noticeable. Let us consider the third. — The stimulation to action of the motive nervous system connected with the speaking organs. — My belief is that here in this medium, which might appropriately be termed, the mental energy of the will acting on the accumulated nervous force of the motor organism of the body, exists the original cause of abnormal speech. I believe that there exists in some persons an idiosyncrasy anjounting probably to an irritability or sensibility of fibre in that portion of the brain which controls the motions requisite for the production of speech, and that this pe- culiarity exposes this portion of the brain to be most easily disarranged, with the result that the organs co-op- erating are thrown into spasmodic action by the ordi- nary mental desire to speak. The peculiarity would appear to me rather a difference in sensibility than in structure, from the circumstance that very many fluent — 24 — THE ORIGIN AND TREATMENT OF STAMMERING speakers if not all persons are, in a measure, liable to the affection. Very powerful causes, such as horror, excessive perplexity, or shame will, under some cir- cumstances, partially paralyze or convulse the power of speech in ordinary persons. The great distinction, however, being that the stammerer requires but a slight cause to overturn the balance of his machinery of speech, while the ordinary individual would require some extreme cause, such as seldom occurs, to affect his fluency, and even then can easily recover again by the exercise of his will and reasoning faculties. Having by this analysis detected what would ap- pear to be the weak point, let us now proceed to the fourth element and find if there, too, exists any de- ficiency that would cause stammering. You will at once agree that there is not the slightest ground for the supposition that stammering is in any way attributable to physical defect or direct physical inaction of the vocal apparatus. The effect of the difficulty experi- enced by the stammerer is, of course, manifest to the observer principally in the organs of speech, yet the real cause of the malady is of a more obscure origin and by no means attributable to malformation of the speaking organs. From an experience of meeting many hundred stammerers, I have as yet never found one case where the difficulty was attributable to wrongly formed organs of speech. The fact that the stammerer can sometimes sing without the slightest difficulty, can oftentimes read aloud to himself without the least fear of hesitation, and can at times speak perfectly words that give him the — 25 — THE ORIGIN AND TREATMENT OF STAMMERING greatest difficulty generally, is sufficient evidence in proof of the above assertion. I do not wish to infer that the stammerer is any different in this respect from other persons. Because he stammers it does not fol- low that his organs of speech are perfect, but he is no more likely to suffer from malformation of the organs of speech than are persons not afflicted with stam- mering. I scarcely think it necessary to offer any further argument in support of my statement that the real origin of the stammerer's difficulty is found in the third element considered. For abstract mind to act on ab- stract bodily organs, it is necessary that there be a medium. In this medium, I believe, exists the real origin of the stammerer's difficulty. Though hesitation is only a thing of degree from the most fluent speaker down to the most convulsed stammerer, yet, practically speaking, stammering does not begin until hesitation has arrived at such a pitch that the sufferer, by the exercise of his reasoning faculties, cannot collect him- self and become master of the situation. The reason that many children do not betray the affliction of stammering until they have attained the age of boyhood is because in early life the mental desire is not excessive. It is probably the same as in any other child endeavoring to be understood. As life advances mental power develops, and when the child has become sufficiently old to use its mental functions to any de- gree, it discovers an inability to express itself, either from hesitancy or convulsive action. This difficulty is owing to the disturbance of mental emotion, the child — 36 — THE ORIGIN AND TREATMENT OF STAMMERING through original physical weakness* not being able to bear more than the ordinary stimulus of the mind and will without betraying its defect. During the earlier days of its childhood, the mental activity was not as great, and hence the child stammered but little or probably not at all. The attention of the child is continually attracted to this peculiarity, which soon becomes second nature to it, and added to the original physical weakness, the constantly increasing mental emotion soon overbalances the equilibrium of control, and although the original physical weakness may almost entirely disappear as the child advances in age, yet the difficulty of stammering remains. It is an impossibility to determine in any case of stammering the exact amount of excess of mental emo- tion or deficiency of motive power. Arguing from a supposition that these two influ- ences, mental emotion and motive power, equally dis- tributed would give to a person the ability to converse without hesitation under ordinary circumstances, I will endeavor to demonstrate by means of bodies of com- parative sizes the difference between mild and severe types of stammering. * There appears to exist in many stammerers a condition predisposed to the development of the defect. This idiosyncrasy exposes the brain fibre to easy disarrangement, and the organs co-operating are thrown into spasmodic ac- tion by the ordinary mental desire to speak. 27 — THE ORIGIN AND TREATMENT OF STAMMERING No. I This body represents a person who can talk without hesitation under ordinary circum- stances. If confronted with embarrassment, excitement, shame, or perplexity, mental emo- tion would increase to a degree sufficient to overbalance motive power, resulting in hesita- tion, stammering, or convulsive action. No. 2 This body represents a stammerer wholly unable to control himself under ordinary cir- cumstances. No2 No. 3 This body represents a person who con- tinually suffers from hesitation or who is addicted to stammering in a slight degree. No. 4 This body represents a most violent and severe form of stammering, oftentimes accom- panied by dreadful contortions of the face and convulsive action of the muscles and limbs. No. 5 This body represents the ordinary individ- ual. Such a person would hesitate ov^y under extreme excitement, and would rarely if ever lose control of his speech. — 38 — No4 No 5 THE ORIGIN AND TREATMENT OF STAMMERING No. 6 This body represents unusual ability to speak with confidence under the most trying test or circumstances, without the slightest uneasiness or apprehension of imperfect ut- terance. The illustrations herewith presented represent but four different classes or degrees of stammering. There will be found to exist as many different degrees of stammering as there are individuals afiflicted, as scarcely two persons can be found who experience difficulty in exactly the same manner. The influences, too, that cause the stammerer to betray his defect may be en- tirely different. One person will invariably stammer when brought into the presence of strangers, but never 'experience much difficulty among the members of his own household. Another will scarcely, if ever, betray his defect before strangers, but will invariably stammer when in conversation with immediate friends. One person can speak from a platform to a public audience after he has once entered into his subject, the great difficulty being in getting started. Another is able to begin without the slightest apparent difficulty, but will continually stammer when he gets warmed up to the occasion. While it may be impossible to analyze the different phenomena of cases of this kind, we can without difficulty draw a parallel between two distinct and sep- arate classes. I will call these for brevity and illus- tration : -29— THE ORIGIN AND TREATMENT OF STAMMERING A THE PHYSICAL TYPE B THE MENTAL TYPE The former (A) is comparatively but little compli- cated with mental emotion, while on the other hand the latter (B) has probably lost much of the original phys- ical weakness, but from the overbalance of the equilib- rium or control, suffers materially from mental emotion and is easily agitated and made worse. Some cases of the mental type, however, retain much of the original physical defect. The nature of the former is almost entirely due to lack of motive power or original physical weakness, while the nature of the latter is almost entirely mental, the result of continually increasing and decreasing men- tal emotion. Stammerers who come under the denomi- nation of Class A are troubled continually, more or less, never much better, never much worse, always about the same. Excitement, shame, perplexity, anxiety, embar- rassment, or impaired health does not much increase the severity of their affliction, while on the other hand stammerers who might be designated as belonging to Class B experience during certain periods and while under certain conditions, scarcely any difficulty, but when suddenly confronted with excitement, shame, perplexity, anxiety, or when suffering from fatigue, ex- haustion, or impaired health, they invariably stammer and sometimes violently. Mr. A has the abiUty to address a public audience with as little trouble as he might experience when read- ing aloud to himself, while Mr. B could read aloud to — 30 — THE ORIGIN AND TREATMENT OF STAMMERING himself with perfect ease and composure, but when called upon to speak publicly, owing to his stronger mental emotions, would be wholly unable to do so with- out betraying his impediment to a very great extent. The different peculiarities of stammering manifested in persons belonging to either class would fill several complete volumes. The constant apprehension of fear on the subject of speaking entertained by the stammerer keeps his nerves continually in a state of agitation and unrest. His anxiety to speak fluently, the dread and fear that he may not be able to do so, together with the humiliation of an exhibition of his infirmity combine to increase the severity of his affliction. Many persons beheve that stammering is the result of nervousness, but a second thought would, I think, convince them that nervousness is more often the result of stammering. This has been my experience, and the proof is evident from the fact that when the stammerer has gained con- trol of his speaking organs, his nervousness has almost entirely disappeared. Having become master of the situation, there is not the least fear or apprehension on the subject of speaking, and thus the one great agi- tator of his nervous system having been removed, gradually the nerves settle back to a normal condition of rest, giving the once nervous and prostrated sufferer complete self-control. Persons who stutter usually suffer only in a slight degree from an excess of meijtal emotion typical with the stammerer. The physical weakness of the stutterer may almost entirely disappear and yet the stuttering habit remain, — 31 — THE ORIGIN AND TREATMENT OF STAMMERING owing to recollection, carelessness, force of habit, and association. The origin of stuttering is not generally attributable to the same source as the origin of stammering, and stuttering is more easily conquered and subdued. This is explained by the fact that when the original physical weakness of the stammerer disappears we have left the mental phase of the difficulty to contend with, while with the stutterer we have but to correct an improper mode of respiration and vocalization, strengthen and develop the vocal and respiratory organs and gain an equilibrium of control. This accomplished we have established a foundation upon which to build a cure. The diagnosis and symptoms of a number of cases that have come under my observation would indicate that not a few persons who stammer and who suffer from excessive mental emotion have also acquired peculiar forms of stuttering. In their strained and labored efforts to give utterance to certain syllables or words they have unconsciously acquired an improper mode of breathing. Losing control of their respiratory organs they become wholly unable to vocalize certain sounds, their efforts resulting in contraction or convul- sive action. Whatever may be the outward manifestation of stammering or stuttering, one who has not passed through the ordeal can form no conception of the mental torture endured by persons who are thus unfortunately afflicted. ,32 — CURABLE AND INCURABLE FORMS OF STAMMERING BY Geo. ANDREW LEWIS Paper read before the Michigan Association of Elocutionists at Ann ArboV, Michigan, January 9th, 1897. Many persons appear to think that the term Stam- mering is synonymous with Stuttering, and that all forms of imperfect speech accompanied by convulsive action or emotion are similar in type. In other words, they do not seem to realize that there is a difference of form in stammering, but regard all forms as stammering, and under this head classify as one many different types. While it may in a general way be correct to classify all under one head, yet, professionally speaking, there are almost as may different types of stammering as there are types of man, and each one has its own peculiar phenomenon. Before entering into a discussion of different forms, it might be well to make a division or classification. 3 —33 — THE ORIGIN AND TREATMENT OF STAMMERING STAMMERING AND STUTTERING While we all know that stammering, as generally accepted, embraces both of these forms, yet each has a distinct and separate meaning and can again be subdivided and admits of numerous classifications. Stammering is more often inherited, the result of a predisposed condition ; while stuttering, which closely resembles it, takes it origin through nervous weakness. However, this is not always the case, as stuttering is oftentimes converted or allowed to develop into stam- mering. Stammering is almost wholly a disease of the mind or a mental condition, while on the other hand, stuttering is generally due to an improper manner of respiration or of syllabication, and is largely an acquired or physical condition. When I state that stuttering is sometimes converted into stammering, I mean that a physical condition becomes a mental one. Stuttering is generally accompanied with more dreadful facial con- tortions and convulsive action of the limbs than stam- mering, and it is partly for this reason (owing to such intense agony and humiliation over the exhibition of his infirmity) that his case develops into stammering. The fatigue, worry, and exhaustion make his condition a mental one. Sometimes we have to deal with cases of this kind that are under process of evolution, and which we term COMBINED STAMMERING AND STUTTERING Stammering never evolves into stuttering, but, as already demonstrated, stuttering, if neglected, oftentimes — 34 — THE ORIGIN AND TREATMENT OF STAMMERING becomes stammering. Persons who suffer from a type of combined stammering and stuttering usually manifest a wrong mode of respiration, are addicted in a slight degree to the rapid repetition of their words and sylla- bles, and yet oftentimes are wholly unable to raise their voice to express a word. My intention is to present to you a number of the most important forms of stammer- ing that are curable and a few that are incurable. STUTTERING The stutterer no doubt is responsible for all the rid- icule that is heaped upon the stammerer and for all the mirth that some people seem to enjoy over his sad con- dition. He invariably repeats his words or syllables in rapid and quick succession, and oftentimes resorts to various physical movements, apparently to aid him in his efforts. He pulls chairs, slaps or pounds himself, involuntarily, rolls his eyes, and contorts his features. Strange to say, I have known some stutterers of this type who proved the most susceptible to treatment, and were entirely cured in an incredibly short time. This can only be accounted for from the fact that the diffi- culty was largely of the physical type, and had little if any mental complication. With obedience to instruc- tions on the part of the patient, and with an ordinary amount of intelligence, any case of stuttering is curable. STAMMERING It can be said of the stammerer that he is generally unable to make a beginning. He knows what he wants — 35 — THE ORIGIN AND TREATMENT OF STAMMERING to say, but is unable to utter a sound. As already ex- plained, his defect is rather one of the mind than of the speech, the organs of speech merely acting as an out ward manifestation of an abnormal condition of th* brain. STAMMERING FROM HEREDITY Probably the most severe form of stammering, and one of the most difficult to eradicate is that which comes from heredity. Such cases are not by any means rare, as a great number of those with which we have to deal originate from this source. There is not the least doubt but that a disposition toward stammer- ing can be inherited and transmitted from one gen- eration to another, and, in this connection, I will say that I know of one family in which no less than sixteen persons are addicted to stammering. This number em- braces brothers, sisters, uncles, aunts, and cousins, and nearly every one of them are troubled similarly. Cases of hereditary stammering in one family rarely bear the same manifestations. The father may be addicted to stuttering of a most violent form, and his son afflicted with a type of stammering that would appear to the ob- server entirely different. Wherever persons in one fam- ily are addicted to stammering, we rarely find two who stammer similarly. In hereditary stammering, we have a condition of the mind that in the beginning is abnor- mal and which requires mental training and discipline to thoroughly eradicate. Cases of hereditary stammer- ing are common, and with proper treatment and care can be entirely overcome. -36- THE ORIGIN AND TREATMENT OF STAMMERING It is generally supposed that stammering itself can be inherited. This, however, is a wrong supposition. A condition, or disposition, favorable to the develop- ment of stammering can be inherited, but stammering itself cannot be inherited. If stammering could be transmitted from one generation to another we would find that children disposed to stammer would exhibit their defect at their earliest infancy. This we rarely find, and, in fact, never unless the child so disposed be surrounded with stammering parents and stammering influences. On the contrary, we find in the majority of cases, that the child stammerer (even where its in- firmity is said to be due to heredity) does not com- mence to stammer when it first begins to talk, or, in other words, its stammering does not begin until after it has acquired a perfectly correct and natural manner of talking. It is said that consumption cannot be inherited. One can be disposed to the development of this dread disease, and the disposition towards it can exist in a whole family. Yet with proper climatic changes and otherwise a means can often be had to entirely pre- vent its ravages. It can, in fact, be so guarded that all danger, or, at least, danger to a reasonable degree, is wholly warded off. What otherwise would have been a complete wreck can sometimes with care from the beginning be made a robust constitution. This also is true of stammering. From its earliest infancy sur- round the child who has inherited a disposition to stammer with persons who talk well, never unduly excite it, never tickle it, avoid for it every possible — 37 — THE ORIGIN AND TREATMENT OF STAMMERING form of sickness accompanied by fever, never subject it to shame or ridicule, or otherwise place it in an embar- rassing position, take it away from every stammering influence and from every person who stammers, allow it to acquire correct articulation and a correct manner of speaking from observation, listening, and mimicry, and look carefully after its health. After it has attained its tenth year guard its morals and habits until its six- teenth year. Feed it on wholesome, plain diet and have it take plenty of out-of-door exercise. After you have done all this you can in nine cases out of ten make a per- fect talker out of what otherwise would prove a case of inherited stammering, but which, if properly taken care of from the beginning, can be largely prevented and in the majority of cases entirely overcome. STAMMERING FROM FRIGHT While, personally, I know of but few cases that owe their origin to fright, yet statistics prove that such cases frequently occur. I have within my recollection a few cases of this kind, and have generally found that they are of a milder form than other cases of which I have spoken. However, among cases of this kind I remem- ber an extremely difficult one. The parents of the boy told me that during his early childhood he had fallen upon a splinter, which cut his mouth badly and tore away a portion of his tongue. The nervous shock and fright thereby occasioned had caused the child to stam- mer, and it was only after a long and persistent treat- -38- THE ORIGIN AND TREATMENT OF STAMMERING mcnt that we succeeded in entirely overcoming his difficulty. It has been claimed that stammering caus/sd by fright is one of the most difficult forms to cure, but from my own experience in the matter such has not been the case. STAMMERING CAUSED BY SICKNESS We not infrequently meet with cases of stammering that began after severe illness. It might be well to state here that in every such case the sickness occasioning the difficulty was accompanied with high fever, diph- theria, scarlet fever, typhoid fever, mumps, measles, bronchitis, etc., etc. The circumstance that it is only in cases of sickness accompanied with delirium that we have the manifestations of stammering would seem to indicate that the fever was wholly responsible for this uncontrollable condition, and largely" responsible for the permanent injury effected. We find stammering follow- ing severe illness only where the latter is of a feverish nature, which would appear to strengthen my argument that stammering is a disease of the mind. Persons who attribute their stammering to illness sometimes find, upon investigation, that their organism was predisposed to the development of their defect. Although some of their ancestors suffered before them from the defect, they probably would never have suffered but for an ill- ness which lowered their vitality, exhausted their en- ergy, and which gave their predisposed condition an opportunity to assert and manifest itself. In the be- ginning their motive power to act was not excessive, — 39 — THE ORIGIN AND TREATMENT OF STAMMERING but sufficient to establish an equilibrium of control. Through illness, the vital energy becoming reduced, their motive power of action became deficient. The equilibrium of control once overthrown offered an ex- cellent opportunity for the rapid development of their inherited condition. This form of stammering is gener- ally very susceptible to successful treatment. STAMMERING FROM MIMICRY My experience has been that fully 25 per cent, of persons who stammer have either acquired their difficulty at the beginning from mimicry or have unconsciously fallen into the habit through association with other persons thus afflicted. At first the habit manifests itself much after the form of stuttering, which, as explained in the beginning, afterwards terminates in stammering. In my experience I have been in communication with many thousand persons who stammer and have person- ally met a great number. From what they have told me in their letters, and from what I have learned of their cases, a large percentage can attribute their diffi- culty only to mimicry or to association with other per- sons so afflicted. Such cases usually rapidly develop during childhood and become chronic as the individual advances in years. You will remember that each case I have cited has been due to some mental disturbance, excepting probably that form which comes from mim- icry. This generally is not a form of stammering, but becomes stammering through worry and continued mental agitation of the sufferer. All cases of stammer- — 40 — THE ORIGIN AND TREATMENT OF STAMMERING ing are either the result of a predisposed condition, are an evolutionized form of stuttering, or are the result of extreme mental effort or agitation. Many children just learning to talk are made to stammer by overtaxing their mental faculties. The parents, noticing the par- ticularly clear enunciation of the child, endeavor to have it recite long sentences and pronounce extremely diffi- cult words, with the result that this practice is often the beginning of stammering. A child should never be tickled or in other ways made to laugh too heartily. There is a place to draw the line, and parents should avoid making their little ones overstep the boundary. I quote from Professor Hermann Klencke: "Stam- mering is not independent ; it is not a disease by itself. It is nothing that a person can have alone and be well in other respects. It is in every case a symptom, only a reflex action of a predominating mental and physical disease." In this I think Professor Klencke is correct. We have many different forms and types of stammering, but rarely find a case that is not accompanied with an ab- normal condition of the vital force and a consequent functional nervous derangement, the perverse action of innervation and muscle. Cases of stammering attribu- table to mimicry are generally not difficult to cure, as the condition is largely an acquired or physical one, and has but little of the mental complication. Speaking of different forms of stammering, probably the most severe type, barring the inherited condition, is what might properly be termed constitutional stammer- ing. — 41-r THE ORIGIN AND TREATMENT OF STAMMERING CONSTITUTIONAL STAMMERING This form of stammering usually accompanies a weakened condition of the whole system, and may be due to overgrowth or by reason of an insufficient supply of vital force. Such persons suffer from general nervous debility, nervous trembling, and weakness of the whole organism. It requires, in addition to the regular course of treatment, the building up of health and the strength- ening of the constitution. This can sometimes be ac- complished in an auxiliary way by medical aid, but preferably by physical and gymnastic exercises. INTERMITTENT STAMMERING Intermittent stammering is a form of constitutional stammering, where the severity of the affliction alternates in direct ratio with the health or physical condition of the afflicted. For instance, these persons find, when their physical condition is good, that they experience but little difficulty, but, on the contrary, when their physical condition is poor, they stammer badly. Some- times for two weeks they will barely stammer once, while during the following fortnight they will stammer con- tinually and oftentimes dreadfully. In the treatment of intermittent or constitutional stammering, particular stress should be laid upon diet and exercise. It has been said of stammering that it is only a species of moral cowardice, arising from physical weakness. This is no doubt largely true in cases of constitutional stam- mering. If we improve the physique in every possible — 42 — THE ORIGIN AND TREATMENT OF STAMMERING way, we restore the natural bravery of the sufferer. Let him retire early and rise early ; take plenty of exer- cise in the open air and undergo at the same time a systematic course of gymnastic training indoors, under the direction of a competent instructor for the develop- ment of his weakened muscles and organs. This aids largely to a successful treatment, and with obedience to instructions, both for his natural defect and for his health, will surely accomplish the desired object. NERVOUS STAMMERING AND STUTTERING While all forms of stammering and stuttering are accompanied by nervousness, yet in the majority of cases the accompanying nervousness is due to stammer- ing, and not, as generally supposed, stammering due to nervousness. Remove the stammering and the nerv- ousness disappears. However, we have in a few in- stances met cases where the nervousness was a part of the man. Professor Klencke says, '*This kind of stam- mering is the hardest to cure and the most common." While I take exception to Professor Klencke concern- ing its being the most common, yet I cannot say but that it is one of the hardest forms with which we have to deal. It bears a resemblance to certain forms of St. Vitus dance, and is influenced by changes of circum- stances, changes of weather, is worse in the mornings than in the afternoons, and is accompanied with facial contortions, active mind, irritable temperament, and lively fancy with forebodings of failure. Notwithstand- ing the obstinacy of this form of stammering, we have never failed in our efforts to overcome it. — 43 — THE ORIGIN AND TREATMENT OF STAMMERING STAMMERING FROM AN IMPROPER MODE OF RESPIRATION There is no doubt but that many types of stammer- ing are accompanied by an improper mode of respira- tion, yet in the majority of instances we find that cases of stuttering are more often associated with this defect than are cases of stammering. However, stammerers of this class are quite numerous. Their chest is usually flat; a deep breath will cause them to cough or gasp. They are averse to contact with strangers and are usually moody and listless. This form of stammering yields readily to treatment. STAMMERING OF THE MIND Stammering of the mind appears as a form that takes its origin where hesitation is developing into stammering, and where it is difficult for the sufferer to control his speech by means of exercising his will or reasoning faculties. Such persons are oftentimes termed flighty. They enter into any undertaking at once with spirited enthusiasm, and abandon it as readily. They are whimsical and erratically engage in every undertak- ing. Their ideas travel faster than they are physically able to execute their thoughts, which not only enters into their every-day life, but is also largely mani- fest in their conversation. They begin to talk, and before they have finished one word they begin the syllable of the word following. Before they have made sense of one sentence, they begin another on probably — 44 — THE ORIGIN AND TREATMENT OF STAMMERING some entirely different topic. Their words are discon- nected and their sentences are slurred. When they are closely observed by persons of superior position and rank they become confused and talk in a disconnected and illogical manner. With the strictest discipline their difficulty can be entirely overcome. STAMMERING THROUGH NEGLECT There is not the slightest doubt but that a few per- sons who stammer or stutter have gradually allowed the difficulty to grow upon them. They do not realize the importance of correct articulation, and allow them- selves to hesitate, mispronounce, and slur their syllables. In the beginning it is probably nothing more than hesitation, but what when they have lost the moral mastery over it? It then becomes securely fastened to them, not to be shaken off. These cases are com- mon, and are worthy of attention. As difficulty of this kind is largely of the acquired or habitual char- acter, it can, with proper treatment, be entirely eradi- cated. THE SENSITIVE STAMMERER All stammerers are more or less sensitive. The majority of them are more, and I have known a few who were less. As a stammerer, I was extremely sensitive over my infirmity and remember once having severely punished a young fellow who imitated my contortions. They do not want you to speak of their affliction, and must be approached in a very cautious manner. Of all — 45 — THE ORIGIN AND TREATMENT OF STAMMERING classes of afflicted humanity, I think the stammerer is the most sensitive. Among them there is a form of the difficulty that is accompanied with an extremely sensitive temperament. We do not find that this makes the case less responsive to treatment, as the stammering disap- pears with the sensitiveness when the patient is put un- der treatment. NASAL STAMMERING Just at this point I wish to call your attention to a form of this difficulty which might properly be termed nasal stammering. This kind of stammering is not by any means rare, and has generally been considered as not the easi^t type to cure. The sufferer, instead of allowing his words to pass out through the mouth in the natural manner, throws his head back and forth with convulsive action. There is a peculiar nasal sound, and the air, which should pass through the mouth, is forced out through the nostrils, giving the words an unnatural and rather disagreeable utterance. All forms of nasal stammering can be readily overcome and entirely eradicated. SILENT STAMMERING Silent stammering is common, and is often termed " Stoppage in Speech." There is no facial effort or other observable indication of speaking. The effort is wholly a mental one, — not even the expression of the eye or a muscle of the face indicating the struggle ^46- THE ORIGIN AND TREATMENT OF STAMMERING within. The word, when it does come, is often mis- pronounced or pronounced in an incoherent manner. If allowed to repeat the sentence, the speaker will pronounce his words perfectly, but usually it requires several consecutive trials. When you ask him a ques- tion suddenly, if embarrassed he will stand perfectly transfixed, unable to utter a word. This form or type of stammering has many peculiar and interesting phe- nomena in connection with it, and often enters into various other combinations. It can be entirely over- come with proper mental training in addition to the general course of treatment. BOISTEROUS STAMMERING Contrasted with the silent stammerer we have the boisterous stammerer. This man tangles up his words in a most fearful manner, gasps for breath, utters various hissing and gurgling sounds, and throws himself con- stantly back and forth, or from side to side, stammers often, contorts his features and muscles, and otherwise makes himself generally obnoxious. While this form of stammering is apparently severe, yet it oftentimes happens that it is very easy to cure. CONTINUED STAMMERING While all forms and types of stammering are to a greater or less degree continued, yet there is a distinct form which can be described only under this heading. The continued stammerer is an inveterate stammerer. — 47 — THE ORIGIN AND TREATMENT OF STAMMERING He always stammers and stammers always. There is no change in his manner of stammering from one year's end to the other, or even from one day to the next. Unlike the intermittent stammerer, he never experiences spells when he talks easily and when he talks worse. Climatic changes, changes of health, excitement or embarrassment do not enhance the severity of his im- pediment. He has no particular words or sounds that give him great difficulty, but all words and all sounds bother him equally. He is not insensitive, yet he is not as sensitive as persons of the intermittent class. Such cases of stammering are rare, and I have met comparatively few of them in my experience. How- ever, those I have come in contact with have been en- tirely successful in overcoming their defect. THE DESPONDENT OR SORROWFUL STAMMERER All stammerers are despondent at times, and the majority of them are sorrowful, but there is one class among them always despondent and always sorrowful. They appear to carry around with them the burdens of the whole world. They are moody and whimsi- cal, their spirits rarely rise above a certain level. That level is the point where sorrow can be turned into joy. George Eliot, speaking of the secret sorrow, says, "These things are often unknown to the world, for there is much pain that is quite noiseless. Many an inherited sorrow that has marred a life has been breathed into no human ear." They are not always burdening you with their cares and troubles, but appear -48- THE ORIGIN AND TREATMENT OF STAMMERING to prefer to suffer in silence. They talk but little, probably because they are unable to talk well. Occa- sionally you will come upon one who, unlike the others of his type, will continually seek to tell you of all his cares. He rarely, if ever, tells you anything of a cheerful nature, and is not much interested in anything cheerful you may tell him, but talk to him of any- thing sorrowful and he is at once interested. It reminds him of something he has heard before, but the tale he will tell you will be the more sorrowful of the two. Such persons usually require rigid discipline, and should ever be encouraged in that which is cheerful and never provoked. INCURABLE FORMS OF STAMMERING Two gentlemen called upon me at my Institute with a young man, stating that they wished to place him under treatment for stammering. They had been referred to me by one of the hospitals of Detroit. After making numerous inquiries of the father, I addressed my conversation to the boy. I asked him how old he was. He replied that he didn't know. "Why, yes you do," said the father, *' you're thirteen," and the boy shook his head. I inferred that the boy was unable to say thirteen, and asked him again to tell me how old he was. He still shook his head and refused to reply. Notwithstanding the requests of his father and my ear- nest solicitations, nothing could induce the fellow to say thirteen. He would not even make the attempt. I have no doubt but that he could have said it with extreme 4 —49 — THE ORIGIN AND TREATMENT OF STAMMERING effort, and explained to him that I wished him to try, in order that I might gain a better knowledge of his diffi- culty, but to no effect. The young man was unusually large of his age, and might have been taken for a boy of eighteen. His father took me into an adjoining room and told me that the boy had a large pocket knife in his possession, and that if I could get him interested in talking about the knife, I could probably gain an idea of his stammering. Strange to say, the only subject the boy would talk upon was the knife, and it was indeed pitiful to listen to his vain efforts at talking. He stam- mered worse, I think, than any person I had previously come in contact with, and the contortion of his face was extremely painful. I asked him a number of questions regarding his knife, and he endeavored to explain its utility to me. It had a number of blades for special purposes, and he became extremely enthusiastic over its use. I tried to draw him out on other topics, but he would talk of nothing else but his knife. I had not the least hesitation in pronouncing his case an incurable one. Among persons who stammer, as well as among persons who do not stammer, we find people who have not the ordinary amount of intelligence. Such persons, among stammerers, although rare, are incurable. I discharged a gentleman from my treatment once and pronounced his case an incurable one, not because he had an insufficient amount of intellect, but wholly for the reason of disobedience. He was a man of be- tween 3 5 and 40 years of age, and one of the most severe cases of stammering^yoiu^can imagine. During the first ten days of his ,t^^S^t,/S^was<^tremely enthusiastic, JULl — ^ THE ORIGIN AND TREATMENT OF STAMMERING but inclined to be unruly and hard to discipline, which culminated in open disobedience to my instructions. He would rarely, if ever, disobey in my presence, but upon dismissal from the school, would act in direct dis- obedience to my wishes. | One of the principles we enforce in our school during treatment is the total absti- nence from the use of tobacco and liquors. "I While I have no direct knowledge that this man used the latter, still I do know that he smoked constantly, and I have every reason to believe that he was also addicted to the Hquor habit. We rarely come across a pupil who will openly disobey our instructions, but the instance I have pointed out is one case that I think can be counted an incurable one. Incurable cases of stammering are very rare, and can be classed almost wholly under the two headings. Disobedience and Lack of Intelligence. \ Any case of stammering, no matter how severe, is cur- \ able with proper treatment, obedience to instructions, I and the ordinary amount of intellect to back up the/ exercises. CHILD STAMMERING A paper read before the Michigan State Association of Elocutionists at their annual Convention at Grand Rapids, Mich., December i8, 1897. I HAVE known of very few child stammerers. In other words, the great majority of so-called stammering children are, correctly speaking, stuttering children. Stammering takes its root in the early life of the child, in the form of stuttering, from which afterwards develops a mental complication, commonly termed stam- mering. There is, however, sometimes found an excep- tion to this, inasmuch as I have known a few children who apparently had all the symptoms and conditions of stammering, but in the large majority of cases stammer- ing does not develop until stuttering has first ravaged its victim. The fact that stuttering is largely manifest in so-called stammering children, and stammering more often found in grown persons, is no evidence but that stuttering may also be found in grown persons, and stammering found in children. The child stutterer does not always develop into a stammering adult, but in nine cases out of ten such is the case, unless something is done in early life to pre- vent this evolution which often takes place. — 52 — THE ORIGIN AND TREATMENT OF STAMMERING I have spoken of stuttering and stammering, and in order to make myself more clearly understood, I will briefly define the difference between these two terms. Webster and others use them as synonyms. It has been found, however, that while one bears a relation to the other, there is, scientifically and technically speak- ing, a wide difference between them. Stuttering is physical, stammering mental. Stuttering in a sense is to stammering what the lamb is to the sheep, the gosling to the goose, the fawn to the deer. I make this state- ment in a general way, as there are some cases of stam- mering to which this comparison will not apply. In such persons of hereditary tendency toward stammer- ing, the first appearance of the defect is in form that of stuttering, which usually rapidly develops into the awful condition of the stammerer. The original defect is planted in the prenatal life of the child and there lies slumbering in embryo, waiting only some mental agita- tion to arouse and awaken it. The torch once applied the mischief is done. The manifestations at first are in the large majority of cases those of the stutterer, which at this age could be easily smothered, but as the child advances in years its defect grows upon it. The men- tal agitation increases in proportion to the mental prob- lems of life, which are daily thrust upon it, and thus in contrast, as the rosebud in time unfolds to view the beauty of its hidden loveliness, there develops in the mind of the stammering child as he advances in years those abnormal conditions which lead to the awful tor- tures of stammering. We know of many cases of stam- mering, and know of as many attributed causes. One — 53 — THE ORIGIN AND TREATMENT OF STAMMERING \ says his stammering originated from fright, another from sickness, another from mimicry, another from associa- tion, another from accident. Nearly every stammerer attributes his stammering to different causes, and yet in the large majority of cases they can all be attributed to one origin. These so-called causes are merely aggra- vations which serve to awaken that which already ex- isted,^ but which was dormant. It may have existed as a result of heredity, or it may have taken its origin from an unknown source. At all events, these cases of stam- mering that are said to have originated from fright, mimicry, association, sickness, and many other causes, are but the external manifestations of an abnormal con- dition of the mind which had previously existed un- manifested. Anything that affects or agitates the brain of one predisposed to the development of stammer- ing is likely to cause stammering, or rather I should have said stuttering, as I have explained that the large majority of so-called stammerers were in the be- ginning nothing more nor less than stutterers. Speak- ing of the child stutterer, it is not by any means difficult to cure, but the child stammerer is not as easily managed. I have spoken of stammering, of stuttering, and of combined stammering and stuttering. Stuttering when found in grown persons is generally a form which has been acquired. Had it been of hereditary origin, it would no doubt have developed into stammering before the age of manhood. Stuttering is largely physical, and not by any means difficult to cure. We have had several cases of lifelong stutterers who have been entirely cured in -54- THE ORIGIN AND TREATMENT OF STAMMERING less than two weeks. One of these cases, at this writing, has stood the test of three years, another a year and a half. Such rapid cures, however, are exceptional among cases of stammering, which have usually required a longer period. The difference in the time required to effect a cure in cases of stammering and those of stut- tering is accounted for in the following manner: With stuttering we have but the physical to deal with, while with stammering we have both the physical and mental. Stuttering is largely due to a wrong manner of breath- ing and respiration, and is manifested by the rapid rep- etition of words and syllables, oftentimes accompanied by convulsive action of the muscles. Establish a correct form of respiration, make the stutterer talk slowly and behave himself, and you have a foundation laid upon which to build the cure. Not so, however, with the stam- merer. With him we have added to an abnormal manner of breathing and respiration the mental phase of this difficulty, and thus when we have entirely overcome the former we have left the latter complication to deal with. Since stuttering, which is not by any means difficult to cure, is more often found in children and stammering more often found in adults, it becomes parents to arrest the stuttering habit in their children before the difficulty de- velops into stammering, with all its mental complications. / Age has but little to do with the chances of recovery in any case of stammering, as much depends upon the application of the pupil to the duties required of him and his aptitude and comprehension. Entirely satisfac- tory results can rarely be obtained in children less than ten years of age. However, at the age of ten and after- — 55 — THE ORIGIN AND TREATMENT OF STAMMERING wards, if the child is intelligent, every vestige of its impediment can be entirely eradicated. Children are imitative, and thus they readily pick up the work of the classes. Quintilian says, ** Before all, let the nurses speak properly." The child will hear them first and will shape its word by imitating them. No child should be kept under the influence of a stammering parent. We find in nearly every case where one of the parents stammer, at least one or more of the children are similarly afflicted. Sometimes whole families stammer. I know of one fam- ily where father and mother stammer, every one of their children stammer, their grandchildren stammer, and one of their great-grandchildren stammers. If possible, which is rarely the case, the child of the stammering parent should be adopted into another family, where it will not be brought into association with the habit of stammering, until it has passed its fifteenth year. There is then but little danger, as but a small percentage of persons commence to stammer after that age. We might expect the child of stammering parents, which is brought daily in contact with this awful habit, to imitate what it sees. Old Roger Ascham says : " All languages, both learned and mother tongue, are gotten and begotten solely by imitation, for as ye used to hear so ye learn to speak. If ye hear no other ye speak not yourself, and whom ye only hear of them ye only learn." Thus, what can we expect of a child, predisposed as it may be to the development of stammering, surrounded with every persuasive stammering influence and in other ways sub- jected to the exposure of this contagion? We can only expect that it will stammer, which we find to be the -56- THE ORIGIN AND TREATMENT OF STAMMERING result in nine cases out of ten. I speak of it as a con- tagion, from the fact that many of these stammering children would never have stammered but for having been brought into contact with it from association with their parents and otherwise. When only one of the parents stammer, their children oftentimes escape it. Where both parents stammer the doom for their children is inevitable. I have known of several such unfortunate cases and the results have always been the same. Children who are thought to be disposed to the de\ velopment of stammering shaujd never be severely pijijiA isl^ed^: they should never be subjected to fright or ' danger. They should be kept away from any person so afflicted and should be carefully protected from all kinds of sickness accompanied with fevers, such as measles, mumps, scarlet fever, diphtheria, whooping cough, etc. Such forms of sickness, by lowering the vitality of the child and by agitating the brain, are likely to bring to the surface that which lies slumbering in a dormant condition. The temperament of the child who suffers from either stammering or stuttering is usually an active one. I wish also to say that while nervousness is sometimes associated with stammering, during the child life of the sufferer there is but little nervousness observable. I do not believe the stammerer, as a child, is more nervous than children not thus afflicted. It is probably owing to his stammering that we notice his nervous condition. When he grows to boyhood and becomes sensitive over his infirmity he begins to show signs of nervousness, he feels humiliated over his stammering, is laughed at by — 57 — THE ORIGIN AND TREATMENT OF STAMMERING other boys, is pushed aside at every turn, until at last, like a hunted deer, he turns upon his antagonists and tries to defend himself. He finds, however, that he is one against many, and, as is often the case, withdraws himself from every social and pleasurable pastime. As a result of his suffering and of the continued strain from making an exhibition of himself, his nerves become un- strung, he continues to suffer from day to day, from month to month, from year to year, until at last the equilibrium of control is overthrown and his nervous- ness becomes a part of the man. Thus it is that all persons who stammer are nervous. As a proof of this, we find that when a stammerer is cured his nervousness rapidly disappears. The fear and humiliation of stam- mering taken from his mind his nerves gradually settle back into a relaxed condition. I have been asked what I would do providing I had a child who was predisposed to the development of stammering. This question is rather a complex one to answer, from the fact that what I would do other persons might not feel disposed to do. In the first place, a child, whether disposed to the development of stammering or not, should be kept separate and apart from every other person so afflicted. If the parent of the child stammers, and there is no way to separate them, all further advice would be useless and worthless. A stammering child, until its impediment can be cor- rected, should never be allowed to attend public school, nor any other school where it will be brought into contact with other children. This is beneficial alike to the stammering child and also to its associates with -58- THE ORIGIN AND TREATMENT OF STAMMERING whom it comes in contact. It is applicable to the stammering child from the fact that a cross teacher and the teasing it may receive from the other children will serve only to aggravate its difficulty and confirm the habit. It is deleterious to any child, whether disposed to stammering or not, to be constantly associated with stammering. Those of you who have a knowledge Df child life know that any child hearing another stammer may endeavor to imitate it, and may either acquire the habit or receive a vivid mental impression of what it has heard. Children are great imitators. It is largely through their keen imitative faculties and imaginative mind that so many of them acquire such a store of knowledge at such an early stage of life. Do not allow your child to imitate or mock a stammerer, nor should stammering children be thrown in contact with other children not so afflicted. Never laugh at, tease, nor scold a child because it stammers. A man brought a little boy to me and asked my opinion and advice regarding its impediment. I motioned him into the parlor and requested him to be seated, at the same time giving a chair to the little boy. The child was about seven years of age and a bright, apt little fel- low. After talking with the father for some minutes relative to the boy's stammering, I turned and asked the boy his name. Like many children of his age, the boy acted rather timid and seemed inclined to shrink away ^ from my question. He made an effort to speak, but was unable to do so. He stuttered and stammered terribly. " Come," said the father, '' spit it out or I will \ make you." "No you won't," I answered, ''the boy j — 59 — THE ORIGIN AND TREATMENT OF STAMMERING has more sense than you have." I motioned the boy toward me. Fearful of his father's look, and in response to my kind tone, he came and slood between my knees. *'Now," said I to the father, "you go into the adjoin- ing room and leave this little fellow to me, and I will tell you when I have talked to him a little while all about his stammering." I sat the little fellow on my knee and told him of all the sights at Belle Isle, of the animals, the monkeys, of a bicycle ride I had taken the day previous, and many other things I thought would interest him. After a while he forgot the reprimand and cross words of his father, and his timid counte- nance became radiant and smiling. He told me his name, where he lived, how old he was, his little play- mate's name at home, and in many other ways enter- tained me. During this time he stuttered but little. He told me of many little boyish things, and in a pretty little childlike way, I stepped to the sitting-room door and told the father I was now ready for him, and when he put in an appearance the countenance of the child fell and he once more became timid and fright- ened. I told the boy's father what he should do and severely censured him for his actions and manner. He took my advice rather reluctantly, but whether he applied it or not I do not know. This much, however, I do know, that by a careful hand, a kind heart, and words of advice and caution, the poor little stammering child could have been very much helped, if not entirely cured. The best friend it ever had in the world unfortunately died, and thus I am led to believe the little fellow will grow up and endure all the miseries — 60-- THE ORIGIN AND TREATMENT OF STAMMERING and tortures of stammering. When the stammering child is too young to be sent to an institution for training you can do much for it by treating it kindly. If it needs a whipping give it one, if you believe in whippmg, but never whip it for stammering. Do not indulge it on account of its stammering nor give it to understand that it is sympathized with in its affliction. Treat it firmly yet kindly, and never grant it a request until it has asked for its want in a careful manner. Many crippled, blind, and otherwise afflicted children are indulged on account of their in- firmity. While I know little regarding blind persons or cripples, stammering children should be given to understand that they are in no way privileged on ac- count of their stammering. Do not treat their stam- mering as indifferent, rather give them to understand that when they stammer they are breaking one of the rules of etiquette ; that it is equally as wrong to stammer as not to remove their hats in the parlor ; as wrong to stammer as to go to the table with soiled hands and un- combed hair ; as wrong to stammer as to answer " no " when they are asked to do an errand. In fact, teach them that to stammer is wrong, but in doing so be careful to advise them as to what is right. Whenever you correct or punish a child for a misdemeanor, tell it of its error, unless it otherwise knows, and advise it of the right. Many parents are indifferent to their chil- dren, and stammering children are no exception. They whack them about, give them just so many whippings a week, whether they need them or not, send them from the table when company is present, and otherwise — 6i — THE ORIGIN AND TREATMENT OF STAMMERING neglect them. Whatever you do, don't belittle a child, especially if he is a stammering child. On the contrary, make him your equal, your associate, and by proving your interest and friendship in his welfare you will make him your lifelong friend. If the parents of stam- mering children would advise their children in a kindly manner, correct them when they make an error, caution them that they must not stammer, and in many other ways treat them with firmness and a kindly spirit, there would be but few stammering men and women during the next generation. —62— DIAGNOSIS AND TREATMENT OF OBSTINATE CASES OF STAMMERING Few persons understand how to correctly diagnose a case of stammering. In fact, so little is known of the disease except by a limited few who have made the subject their life study, that I doubt if any of my read- ers, physicians and teachers included, have ever at- tempted it. Before a stammerer determines upon a course of treatment, whether under a private tutor or at an institution, he should first take pains to see that his case has been carefully studied and correctly diagnosed. His counselor should know every peculiarity of his in- firmity before the first step is taken toward radical treatment. Otherwise he will be in as bad a condition, as far as the chances for his recovery are concerned, as the man who would submit himself to a critical opera- tion for a hidden tumor, allowing his surgeon to cut and hack his body to pieces in a vain endeavor to lo- cate the seat of the trouble. Fortunately, however, contrary to the general rule of treating stammering, the skillful surgeon, before making an incision with his -63- THE ORIGIN AND TREATMENT OF STAMMERING knife, knows well what he is about to do. He has thor- oughly studied his patient's trouble and has made a thorough diagnosis of the case. This should also be done in every case of stammer- ing where successful treatment is contemplated. There are no fewer than twenty or more entirely different and distinct types of stammering and stuttering, and there is no set plan or code of rules or exercises that will apply to all cases alike. Each case, while treated from a com- mon basis, must also receive individual care and in- struction, according to the indications and manifestations apparent. Temperaments are not all alike and disposi- tions vary. Thus, a treatment, in order to be success- ful, must not only aim to establish a fixed rule, but will also require to adapt itself to each and every varying case. With a thorough knowledge of the many differ- ent types and forms of stammering and stuttering, the reader can, without much trouble, form a correct idea in any case, and after arriving at a conclusion as to the type of stammering we require only a knowledge of the principles and rules required to establish a cure. We will discuss this latter at the conclusion, and will give our attention now to establishing a knowledge leading up to the diagnosis of a case. Let the reader imagine himself with me in the capac- ity of an instructor to whom Mr. B presents himself for consultation and advice. To make the case more interesting I have selected as a subject a man who has called upon me just previous to this writing, and I want you, reader, to come with me into the consultation room, where we will make our investigation and form -64- THE ORIGIN AND TREATMENT OF STAMMERING our conclusions from which to base the diagnosis of his case. First, we draw our subject out in conversation. Second, have him read from a book or newspaper. Third, ask him to repeat with us in concert the words and chief obstacles that have proved themselves difficult of utterance for him. We ask him his age, study the manner of action, his ease or uneasiness, his contor- tions, if any ; his respiration, his sitting or standing posi- tion, the condition of his health by the appearance of his physique, the tone of the voice, the articulation, the chances or opportunity for physical development, the inclination for using synonyms or for substituting easy words for difficult ones, and thus, by observation and by putting a hundred and one or more questions, we learn all we can about the history of the case. In answer to my questioning he tells me that his mother and one of his elder brothers stammer. This, of course, would naturally indicate a case of hereditary stam- mering, but before forming a conclusion we must make a further investigation. He says he did not commence to stammer until after he had passed his tenth year, and states that he is now thirty-two years of age. He has a child (a boy) five years of age, who stammers violently, but who did not commence to stammer until after he had passed his fourth year, up until which time he had talked perfectly. In answer to further inquiries as to the probable cause of his stammering, he says that neither he nor his parents noticed any apparent difficulty in his speech until after he had mimicked a stammerer at the age of ten. 5 -65- THE ORIGIN AND TREATMENT OF STAMMERING This adds a new phase to the case. The indications point to heredity on one hand and to mimicry on the other. A question naturally arises. Who can say whether the boy would have ever stammered but for his sin of imitation and mockery? To arrive at a satisfactory answer to the problem, let us determine whether the case be one of stammering or stuttering, which conclusion in itself will point to the origin or cause. If upon further investigation we find it to be a case of stammering, we must conclude that its origin is due to heredity ; if a case of stuttering, there is a chance that it may be resultant from mimicry. Stammering takes its origin in a different way from stuttering, the former being purely mental, while the latter is generally the result of habit. A condition disposed to the development of stam- mering can be inherited and transmitted from father to son and from one generation to another, and while this claim is also made for stuttering, the writer has never known of such a case. Stammering is due to an original physical weakness in that portion of the brain which governs and presides over the faculty of speech,* and differs from stuttering in this, that the latter is due entirely to wrongly formed habits of respiration and an incorrect manner of vocali- zation. We must therefore conclude, if we can show that our subject's defect is due to heredity, it is a common ♦See footnote on page 27. — 66 — THE ORIGIN AND TREATMENT OF STAMMERING case of hereditary stammering, while on the other hand, if shown that his trouble is due to mimicry it would appear as nothing more nor less than a case of simple stuttering. How shall we proceed to determine whether it be due to mimicry or heredity, upon which decision we shall base our diagnosis? In answer to further inquiries he states that he can control himself to a degree in the presence of strangers, but that he stammers badly in the presence of his inti- mate acquaintances or in talking to the other members of his own household. This is an evidence of stammer- ing. The stammerer can, by exercising his will and summoning up moral bravery, control himself before strangers to a remarkable degree ; in fact, in this way he is oftentimes wholly able to conceal his impediment. Peculiar as it may seem, he is apparently unable, how- ever, to talk well in the presence of intimate acquaint- ances. Klencke, speaking of the difference in manifesta- tions between the stammerer and stutterer, remarks that " The stammerer usually speaks better when he is observed and thus forced to pay attention to himself. The stutterer immediately begins to stutter violently when he is observed." Before further investigating the case before us, allow me to argue an explanation for the above remarkable circumstance that a large number of stammerers can talk better to strangers than to their intimate acquaintances or relatives. When talking to near friends or to intimate acquaintances the stammerer has nothing to conceal. They know he stammers and there is therefore but little, if any, humiliation in committing such an offense. The -67- THli UlilGlN AND TREATMENT OF STAMMERING will becomes relaxed and with it a relaxation of motive power, followed, as is natural to suppose, by spasmodic action typical of the stammerer. When talking with strangers, before whom the stammerer does not wish to make an exhibition of his infirmity, there is constantly a nervous tension of the mind, an effort toward the gener- ation of will power, and a consequent increase of motive power. Thus follows a temporary better talking, but when relaxation does come the effect is generally de- pressing. The labored effort of the stutterer when attempting to talk before strangers is scientifically explained from the fact that the increase of difficulty under such condi- tions is due to the rapidity of his thought and the rapid succession of new ideas that crowd his brain. The result can be compared to the panic that ensues at a fire in a theater when three or four thousand people attempt to crowd their passage through a four-foot door in their anxiety to get out. Let us now return to our subject who, in stating that he stammers but little in the presence of strangers and much in the presence of intimate friends, has wound about himself a supporting evidence leading up to a case of stammering. I have asked him whether he can read aloud without trouble in a room by himself, to which he answers that he cannot always do so. This can be taken as a further evidence of stammering. The stutterer can always read aloud without trouble, providing there is no other person in the room and he is unaware of the pres- ence of listeners. An explanation for this is also em- bodied in the preceding argument. — 68 — THE ORIGIN AND TREATMENT OF STAMMERING His replies to my questions regarding his stammer- ing show considerable contortion of the facial muscles, but unaccompanied by spasmodic action. This would appear as a fourth link in the chain pointing to a case of stammering. The facial contortions of the stammerer are slowly drawn, in which respect they are different to the facial contortions of the stutterer, which usually occur with spasmodic action. The stammerer may dis- tend his mouth like a funnel and keep it in that position, vainly endeavoring the meanwhile to speak. He may drop his head on his chest, toss it back or sideways, or his features may distort to a degree almost beyond recognition. On the other hand he may widely open his mouth in attempting vocal utterance, compress and hold the lips tightly glued together in his efforts to utter closed or explosive consonants, but with all this his actions are in contrast with those of the stutterer, who behaves himself in a more boisterous manner. In answer to further questioning as to what condi- tions cause him the greatest difficulty, he tells us that it gives him the greatest difficulty to relate a story or tell of an incident. He was present at the Pullman strike in Chicago, but has never been able to tell what he saw there. This is indicative of a peculiar mental condi- tion found only in the stammerer. The mind, in reach- ing out for new ideas to graphically portray in words the pictures of the imagination, is drawn away from the careful vigilance necessary to co-ordination and harmo- nious action of speech, and thus in this way the concentrated effort of the will to speak properly is weakened. The stammerer who is able with care and -69- THE ORIGIN AND TREATMENT OF STAMMERING watchfulness to control his speech is oftentimes over- thrown when this vigilance is withdrawn. We must conclude, therefore, that this statement on the part of our subject but strengthens the evidence leading up to a diagnosis to stammering. He says that he does not stammer as badly in argu- ment as in ordinary conversation. This would appear as a contradiction to my previous argument, but pecu- liar as it may seem, the stammerer is generally able to argue well, especially when he warms up to his subject. This can be explained from the fact that in argument the mind dwells upon what we are about to say, rather than upon the manner in which we are to say it, and thus temporarily our thoughts are taken away from the difficult obstacles that usually present themselves. While the stammerer, as already explained, usually has the greatest difficulty when he relaxes his mind from carefulness of speaking, yet in argument the order of things in this respect is generally reversed. He usually talks better in argument than ordinarily. It is when relaxed and indifferent that he usually has the greatest difficulty. In argument the mind is active. There is no doubt, also, that the desire to win acts as an incentive or generating influence to motive power, and thus affords stimulus of mind sufficient for the proper co- ordination of all the functions and organs concerned in the production of speech. It would appear, therefore, from this that what would at first seem a contradiction to former argu- ments can be thus scientifically explained and adds another link to this interesting chain of evidence. — 70 — THE ORIGIN AND TREATMENT OF STAMMERING Strange as it may appear to one unacquainted with stammering, nearly all stammerers have their pet words which prove difficult of utterance for them. One stam- merer cannot begin the letter '' t," while another, who has no difficulty with words commencing with "t," can- not articulate words beginning with "b." Nor is this difficulty in a single case confined to but one letter of the alphabet, as the great majority of suf- ferers find equal obstruction in the utterance of different letters. To make myself clear on this point, I wish to explain that the letter of itself does not often cause the obstruction, as most stammerers can articulate any let- ter of the alphabet separately. It is generally when the letter in question forms the beginning of a syllable or word. However, there are exceptions to this, as many stam- merers are utterly unable to utter the vowels. These obstructions appear to arise only under cer- tain conditions, according to the condition of the health, the state of the nerves, or the repose of the mind. There is a wide difference among stammerers, scarcely two per- sons being afflicted exactly in the same manner. You have heard the old adage that every sparrow is a bird, yet every bird is not a sparrow. In the same sense stammering is stammering, and while all cases do not bear the same outward manifesta- tions, all are substantially the same, the difference in cases amounting only to the difference in temperaments or in the severity of the case. The letters or combination of letters upon which one stammers has something to do with determining the »-7i — THE ORIGIN AND TREATMENT OF STAMMERING type of stammering, yet no definite conclusion can be arrived at from letters alone. Our subject whose case we have been examining tells us that words beginning with "b," "t," and " m," prove the greatest obstacles, while words commencing with other letters prove an occasional hindrance. However, the three mentioned are his greatest ob- stacles, and he adds that always, unless very careful, he has great difficulty in articulating them. Notice that he says "unless very careful." This suggests that with carefulness he can overcome them, and would appear as an indication of stammering, as we have shown that the stammerer can by the exercise of his will partly or wholly control his stammering. What shall we say of his difficult letters? Stammering, it is authoritatively stated, is manifested principally in the articulating organs, which temporarily become glued together. Stuttering, on the other hand, is manifested principally in the organs of respiration, without the articulating organs being primarily affected. The former is due to a deficiency or lack of exercise and control of the mental energy of the will over the organs of utterance, while the latter is generally due to an improper manner of breathing and vocalization. Pronounce any word beginning with "b," *'t," or "m," — ^battle, tattered, master — and we find that it can- not be enunciated without the action of the articulating organs, the organs between the larynx and the lips. This would appear as an indication of stammering, especially when we note his answer to my next question. He says in his effort to speak he cannot effect a begin- — 72 — THE ORIGIN AJVD TREATMENT OF STAMMERING ning. Sometimes his organs of speech become tightly glued together, at other times there is heard a sound of escaping breath. The stutterer c^n usually effect a be- ginning and either with spasmodic effort or otherwise rapidly repeats or mixes up his words. The stammerer, on the contrary, is usually unable to begin, and either effects a beginning with labored effort of the diaphragm or hisses his words between his teeth. Often his organs of speech become glued together in such a manner as to prevent the utterance of a single sound. The stutterer rarely manifests these conditions, but with convulsive action or spasmodic effort starts his sentences immediately. He may make several attempts but can generally effect a beginning. Thus, when he says that his organs of speech become tightly glued to- gether and adds that at other times he makes a hissing sound or the sound of escaping breath, I take it as a further evidence of stammering. Many stammerers first expel all the air from their lungs, after which they try to talk on exhausted breath. This habit reminds me of the musician who would attempt to get music from an organ after he had allowed the bellows to collapse. Nearly all stammerers can sing without any apparent manifestation of an impediment in their speech. This peculiarity is accounted for from the fact that in music there is rhythm and meter. There are no abrupt begin- nings. All words are commenced in an even drawn man- ner which appears to be conducive to the harmonious action of the vocal organs. One authority says the stam- merer betrays his defect in singing and in measured talk ing, but from experience I have observed that there are — 73 — THE ORIGIN AND TREATMENT OF STAMMERING many exceptions, as only a small percentage of stammer- ers have trouble in singing. However, where one has difficulty in singing the sam.e as in speaking it may be taken as a positive evidence of stammering. In my ex- perience I have known of only a few persons to stammer in singing. In answer to further questions on my part our subject tells us that he frequently meets with hin- drance in his singing, which, as already explained, is evidence of a case of stammering. The stutterer never betrays his defect in singing. He informs us, however, that he can speak fluently and without the slightest ap- parent hindrance when angry. With anger comes de- termination, with determination comes will effort, and with will effort comes control. As explained in the be- ginning of this article, the stammerer can, by exercising his will or determination, partly or wholly control his speech. This explains why when very angry many stam- merers speak fluently. The accumulated nervous force and energy under such circumstances appear sufficient to enable him to exercise the required control. The stutterer when angered or excited is thereby rendered powerless to speak, his efforts to do so generally result- ing in spasmodic and convulsive action. There are ex- ceptions to this, as we occasionally find a man who pre- sents all the manifestations of the stammerer, but who when angry is confused in speaking, while on the other hand I have found that a few stutterers were able to speak quite well when very angry. It may be generally stated, however, that it temporarily improves the stam- merer to anger him, while to anger the stutterer is to make him worse. It is after the anger and passion have — 74 — THE ORIGIN AND TREATMENT OF STAMMERING subsided, when the reaction sets in, that the stam- merer becomes worse. The circumstance that the sub- ject whom we have been examining can speak well when angry may, therefore, be accepted as further evidence of stammering. He says in answer to further questioning that he can talk better to persons before whom he does not wish to exhibit his stammering, but that he is often- times obliged to use synonyms and substitute words to avoid obstacles. Here we have another trait of stam- mering. One of our correspondents writes : ••Many years ago in exhibiting to an acquaintance photo- graphs of a number of my relatives and friends, I came upon the likeness of my brother. The word brother was invariably a stum- bling-block for me, and this time proved no exception. I did not want my friend to know that I stammered, yet how was 1 to conceal it. I endeavored to pass the photograph by without explanation in order to avoid an exhibition of my stammering and contortion, which at such times was most pronounced and severe, but to my embarrassment I was promptly asked by my friend whose likeness it was I had endeavored to pass. Stammerer-like, my mind reached out in a thousand directions for a synonym, but there was no other word that I could use. Trifling as the incident may seem, I shall never forget it. My mind became almost a perfect blank when, quick as a flash, I carefully replied, stammering as I repeated the words : ' That is a picture of one in our family who is next older than I.' It is unnecessary to explain that my reply provoked an abundance of mirth, at the same time I avoided temporarily by my tactics, as many stammerers do, a most embarrassing ordeal of contortion and wasted effort." Our subject says further that he does not Hsp, and that his articulation is perfect when he does not stam- — 75 — THE ORIGIN AND TREATMENT OF STAMMERING mer. He is of a nervous temperament, with a fairly good physique, cheerful in disposition, subject, however, to spells of melancholy. In summing up the evidence we find that every time in answer to questions the manifes- tations all point to a case of stammering. It is, I have no doubt, a case of hereditary stammering which might have remained dormant and never would have manifested itself but for his having imitated a fellow sufferer. The condition, no doubt, was predisposed, and required but the torch of imagination to awaken it and develop its dormant qualities. Thus, while it may be said on the one hand that his stammering was due to mimicry, it was on the other hand primarily due to heredity, and will require the same treatment and care as a case of hereditary stammering. Much has been written and said about the treatment of stammering, and many of those who say and write often know less when they have finished than before they began. I receive many hundreds of letters from stammerers asking about treatment. One man writes and asks whether he is too old for treatment. Another wishes to know whether he is too young ; a third has been an in- veterate tobacco user and wishes to know whether this will ruin the chances for a cure ; a fourth has suffered from ill health and asks whether this fact will bar him out, and thus I might go on and tell about many dif- ferent kinds of people who write as many different kinds of letters about as many different types of stammering. All want to be cured, and all are anxious about treat- ment. The first question that naturally arises in the -76- THE ORIGIN AND TREATMENT OF STAMMERING mind of the stammerer is, " Can I be cured and by what means?" Every stammerer asks himself this question, and the question often repeats itself to him. How shall we answer? It is true that until within the past five or ten years but little advance had been made in the science of treat- ing stammering. Many attempts were made, rewarded with but little success and many failures. A few con- scientious men worked hard in the interests of stam- merers and stammering, while a countless number of "quacks," "professors," and "charlatans" were ap- parently working the stammerer and bleeding him for all and more than he was worth. This, I think, has in a large measure had a tendency to make the stammerer skeptical, even at this advanced era of success in treat- ing stammering, as the older generation of stammerers well remember the rough experience through which they passed, and not satisfied with allowing these things to influence them, they throw this skepticism into the minds of their children and the younger generation, with the result that they also in many instances regard a cure as doubtful. This, to me, is ridiculous. In my mind, it would be equally as fair to say that a man now- adays would surely die from appendicitis because his father or grandfather died from appendicitis. Every- body knows that the chance of death from appendicitis (once so fatal) has been lessened to a remarkable de- gree within the last few years, owing to the rapid strides in science and surgery. During our fathers' and grandfathers* time the deaf mute was obliged to converse entirely by signs and by — 77 — THE ORIGIN AND TREATMENT OF STAMMERING the use of his fingers. Since then large institutions have been established all over the country, where these unfortunates are taught to converse with oral expres- sion. Note, also, the advance in the use of medicine. Compare the old methods with the new. In short, comparisons without number could be drawn to show the remarkable advance of science, art, and learning in every imaginable way. Old fogyisms and old-time ways are being rapidly supplanted by modern methods in almost every science, art, trade, and profession, and thus I claim that it is both wrong and unjust for those who are familiar with the unsuccessful attempts made to cure stammering years ago to allow this prejudice to influence them either in the matter of their own cure or a cure for any other unfortunate. That stammering has been cured, can be cured, and is being cured, hundreds of living monuments to success- ful treatment bear testimony. It is true that there are still, and no doubt ever will be, that class of charlatan quacks who never do what they profess to do, but we find this element in every walk of life and in every profession. But this fact should not prejudice the stammerer against those who are truly endeavoring to benefit him. Would it not be equally as fair to say that all pro- fessing Christians are hypocrites because a few are hypo- crites ? Shall we condemn the many for the errors of a few, or, on the other hand, shall we condemn the few for the errors of the many? Shall we condemn our reputable and educated physi- cians because a countless number of ignorant quacks, -78^ THE ORIGIN AND TREATMENT OF STAMMERING divine healers, and such like, overrun the country, claim- ing to do what they cannot do, and never doing what they claim to do ? Shall we not endeavor to encourage the one and abolish the other? Shall the skilled mechanic be condemned because a more pretentious fellow-laborer is a botch? Why not, then, apply this argument to reputable institutions for the cure of stammering? One reason I have dwelt so largely upon this prejudice and skepticism, which is apparent in the minds of most stammerers, is this, that I believe that in order for a patient to be cured of stammering he should have every confidence in his instructor, and himself fully believe in a successful termination to his efforts. We find this also in the sick patient. Doctors will tell you that in serious illness the chances for recovery are always in favor of the patient who believes in his recovery. When- ever a patient in a sick room gives up his case as hope- lessly lost, the attending physician is handicapped. Hope is everything, but behef is often a reality in itself. This is true especially in the treatment of stammering. That which may be considered lost may oftentimes be regained by confidence. Confidence in the instructor, confidence in the instructions, and confidence in the cure. Confidence welded with hope is the stammerer's step- ping stone to success. I have many times been asked to state what type of stammering I consider the most difficult to cure. In my opinion all forms of stammering are curable, provided, of course, that the patient is well disposed for treatment and obeys instructions. This disposition for treatment may be explained as an anxiety on the part of the patient — 79 — THE ORIGIN AND TREATMENT OF STAMMERING for treatment, a disposition to do everything he is told to do, and obedience in this, that he will do nothing that he is told not to do. Age has but little to do with the chances for recov- ery in any case of stammering. When a child has passed its tenth year it is old enough to intelligently understand and apply all of the exercises necessary in effecting a cure, and not until a man or woman commences to grow childish from old age is that most coveted prize, a cure, a lost possibility. It is largely true with stammering that the earlier we can check it the better, yet,strange as it may appear, many cases of long standing yield to treat- ment more readily than those of more recent origin. The type of stammering in itself does not appar- ently appear as important as the conditions that sur- round it. By this I mean that the ordinary case of stammering, otherwise easy to cure, might prove diffi- cult if surrounded by unfavorable conditions. These conditions are varied and consist of the health of the pupil, his temperament, disposition, and habits, his be- lief or nonbelief in the cure, and his comprehension of ideas and application to instruction figure also as important factors in determining results. Much depends also upon the course or plan of treatment pursued, but more depends upon the appHca- tion of that treatment. A poor system of treatment well applied will invariably give better results than a good system of treatment poorly applied.. A poor sys- tem of treatment poorly applied will give absolutely no results at all, while a good system of treatment well applied will give results that are most satisfactory. — 80 — THE ORIGIN AND TREATMENT OF STAMMERING Under such treatment there is no doubt or question but that the worst possible cases of stammering can be entirely and permanently cured. I have spoken of the health of the pupil as havihg an important bearing in determining his cure. This is true, yet persons in ill health should not be frightened and imagine, because their health is poor, the chances for their recovery are small. The fact of the matter is that the ill health of the stammerer is usually consequent from nervous exhaus- tion caused by the continued unsettled condition of his nerves and consequent drain upon his vitality. Nerv- ousness is the result of stammering, not the cause, and we find under treatment while the cure is being fastened upon a pupil and his old habit of stammering shaken off, the nervous force and energy gradually return, thereby much improving the general health. Having personally known of a number of such in- stances, I have arrived at the conclusion that many stammerers who are constantly suffering from poor health, caused by the disturbed and unsettled condition of their nerves, would grow strong and robust if relieved from this distressing impediment. While I have said the health of the pupil has an important bearing on the treatment, these ill conditions caused by poor health are entirely overcome by the progress of the pupil under treatment. Any good treatment for the cure of stammering will have as a part of its system a regular course of training for the improvement of the general health of every pupil. Classes should be graded, and the exercises adapted to the wants of each particular case. This done, and 6 — 8i — THE ORIGIN AND TREATMENT OF STAMMERING the pupil properly instructed, an absolute cure will re- sult, even though a pupil when he commences treat- ment is suffering from poor health, provided, of course, that the condition of his health is not such as to wholly- unfit him for his work, that the treatment is rational and modern, and the pupil obedient in the fulfillment of his duties. I have said that the disposition of the pupil enters into treatment as an important factor in determining the results of his efforts to overcome his trouble. I have also touched upon this subject and defined why and how a pupil for treatment should be favorably disposed, and were it not for the fact that my remarks on this point have been made perfectly clear, I would dwell more largely upon it now. Suffice it to say that any person desirous of overcoming the lifelong habit of stammering, should while under treatment cultivate a cheerful dispo- sition and entertain at all times a kindly feeling toward all. Having touched upon the question of the health and disposition or temperament of the pupil, let us now dwell for a moment on the habits of the stammerer. I am sorry to say many stammerers and also a fair percentage of young men who do not stammer do things in their early youth, the results of which oftentimes cling to them during the whole i>alance of their lives. These habits are not always at the root of the evil of stammering, but are certainly conducive to it and should be stopped at once. The use of tobacco should by all means be abandoned by every stammerer, as it not only aggravates the evil, but makes the case less responsive to treatment. The use of liquor, especially whiskey, wines, or beer, should — 83 — THE ORIGIN AND TREATMENT OF STAMMERING also be avoided, nor would I advise the use of coffee or tea. Anything that acts as a stimulant or which affects the nerve centers should be carefully put aside. While the temperament and disposition of a pupil under treatment for stammering has some bearing in determining results, the moral aspect of matters must not be lost sight of. Pupils should allow their minds to run only in moral channels and abstain from all those things which corrupt or destroy. When a stammerer decides to undergo treatment for stammering he should at the same time, if he wishes to be successful, make up his mind to undergo, as far as possible, a change in his other habits. If he is already a moral man this of course will be unnecessary. Let him keep his mind pure, ab- stain from excess of any kind, attend properly to his habits of eating and sleeping and take such exercise out of doors as is necessary for his physical well-being. This is especially applicable to cases of intermittent stammer- ing, where the severity of the case alternates in ratio with the physical condition of the sufferer. In the beginning of this article I, as far as possible, told my reader how I would diagnose a case of stam- mering and have subsequently dwelt upon conditions favorable to treatment. This I have done in a general way in answer to many inquiries received from corre- spondents asking me to tell them how to prepare for a course of treatment in order that they might complete their cure in the shortest time possible consistent with the very best results. In continuing I wish to say that the success of any enterprise for the cure of stammering will largely depend upon the permanency of its cures. THE ORIGIN AND TREATMENT OF STAMMERING The cure in itself is not by any means difficult to effect. It is the permanency of the cure that bothers many per- sons, to insure which their every effort appears to be of no avail. Their failure to succeed is no doubt due to their lack of thoroughness and knowledge and their in- attention to the little details that go to make the cure complete. Thus it is I have held out a few suggestions which should receive the attention of every would-be- successful student. There has been much sensationalism associated with some treatments for the cure of stammer- ing which I most bitterly oppose. I am not a believer in the theory that Divine Providence is in partnership with any institution or person interested in the cure of stammering. Neither do I believe that the Almighty has selected out any one particular person to cure stammering and that all other persons are unable to per- form such "miracles." In fact, I do not beheve that there is any miracle-working wonder about it. Matters have even gone so far that an eastern institution adver- tising to cure stammering makes an open claim to support from God. Who can wonder that all this sensa- tionalism and hypocrisy could but result in evil instead of good. These time-worn ideas, however, are rapidly dying out and the stammerer, already warned against them, is giving ear to more rational theories. Speaking further with reference to treatments for the cure of stammering, I could name many of the earlier authorities and give a synopsis of their theories, which, however, would prove of no practical benefit to the reader. Probably the earliest cure of which we have any knowledge is Demosthenes. According to Potter, -84- THE ORIGIN AND TREATMENT OF STAMMERING Satyrus, the Grecian actor, is said by Plutarch to have been responsible for the cure of Demosthenes, who labored under a weak voice, indistinct speech, and short breath, combined with violence of manner. The gen- erally received notion that the cure of the great Grecian orator was effected by speaking with pebbles in his mouth is not borne out by the historical account, for both Demetrius and Cicero tell us that Demosthenes spent months in training his voice, using a looking-glass during his vocal exercises and applying every power of his will to the conquering of his speech defect, the pebbles being but an incidental part of the treatment. Celus (A. D. 1-37) describes various means of cor- recting speech defects, ^tius (600) also blames the tongue, i^gineta did Hkewise. Avicenna (1000), an- other early authority, also lays the fault to the tongue. De Chauliac (1336), a celebrated Italian surgeon, ascribed stuttering to convulsions, ulcers, or other affec- tions of the tongue, to paralysis, or to moisture of the nerves and muscles. His treatment consisted of embro- cations to desiccate the brain, cauteries to the vertebrae, blisters, frictions, and ''gargarisms " for the tongue. Mercurialis (15-84), professor at Padua, Bologna, and Pisa, wrote concerning stuttering in his work, locating its cause in the brain and in the tongue and giving it two species, according as it was produced by abnormal dryness or moisture of those parts. His treatment was similar to De ChauHac's with the addition of systematic exercise of the voice and the body. Canon Kingsley (i860), a celebrated English ora- tor and writer, chaplain to the Queen, was himself a -85- THE ORIGIN AND TREATMENT OF STAMMERING stutterer until he was nearly forty years of age, and has written at considerable length regarding the affection. Kingsley made many mistakes and laid down many foolish and nonsensical rules. He writes that the cause of stammering in three cases out of four can be traced to conscious or unconscious imitation. In a letter to a young lady he tells her she stammers because her upper teeth, like his, shut over the lower ones, and pre- scribes a set of fixed rules, the chief of which relates to opening the mouth widely. He considered boxing an excellent pastime for the stammerer. Had he been a Frenchman, Dr. Potter remarks, he would have said fencing — if an American, base ball. Hunt treated stammering successfully in England for many years and wrote a comprehensive treatise on the subject which Dr. Potter says is sufficiently complex to cause a mania of both the auditory and articulating apparatus. Dr. Klencke conducted an institution in Hanover, Germany, and met with a fair degree of success. In his writings he has advanced a number of different theories regarding the nature of stammering, his ideas of the moral nature of the stammerer being disputed by many other authorities. His patients appeared to be largely of the lower class, or of a low order, but his opinion is worthy of respect from the fact that he had a wide experience. There was one rational feature in connection with Klencke's method which I heartily endorse and recom- mend, that is his endeavors to arouse the will of his pupil and keep it in constant action. He also drilled his pa- tients systematically in the technics of speech. Much — 86 — THE ORIGIN AND TREATMENT OF STAMMERING might be added of the different methods of treatment and theories of early writers, but all are vague and in a sense impractical. The earlier methods of surgery and super- stition have practically died out, and thus it remains for later authorities to advance and carry out more sensible methods of treatment. After years of careful study and investigation I am convinced now rriore than ever that only such methods as are educational in character and graded to suit the re- quirements of special cases can prove efficient. Tricks and secrets are old-time fogyisms. Surgery is no longer employed anywhere. There is no longer room for the charlatan or quack. New ideas, business methods, and modern facilities for treatment have at last proved true the old saying: " You can fool some of the people all of the time ; you can fool all of the people some of the time ; but you can't fool all the people all the time." -87 — HELPFUL HINTS AND EXERCISES BREATHING, SLEEP, MORALITY, DIET, AND Their Relation to a Possible Cure for Stammering BREATHING There are many stammerers who do not appear to understand the benefits to be derived from practicing a correct form of breathing. A correct form of breathing cannot in itself, without other principles, estabHsh a cure for stammering any more than a pile of bricks can in itself form a building without mortar or masonry. It may, however, serve as an auxiliary and when com- bined with other exercises it oftentimes forms a basis upon which a cure may be built. One thing is certain — we cannot produce voice without producing breath. If, then, we have an incorrect manner of producing our breath, what shall we say of our syllables, of our words, and of our sentences? Shall we not go back to the prime disturbance and by the pursuance of a system of — 88 — THE ORIGIN AND TREATMENT OF STAMMERING exercises directly opposed to our wrongly-formed hab- its endeavor to correct the evil and begin anew? Although the origin of all this disturbance with the stammerer can in no way be attributed to his abnormal respiration,* which is rather a result than a cause, yet we should aim, if possible, to correct the habit and sub- stitute for it a correct manner of respiration. If we can succeed in doing this the chances for the permanency of the cure are largely added to, and we can also count on more rapid progress from the beginning. There are many benefits to be derived from the pur- suance of good breathing exercises. Even for those not afflicted with stammering, but for the stammerer, espe- cially, they are particularly beneficial. Let us for a moment discuss the relation of breathing exercises to a possible cure for stammering. Can we by a pursuance of breathing exercises in any possible way influence or strengthen that which directs and controls all move- ments of the body — the brain? When we wish to strengthen any function or muscle of the body we exer- cise it. This granted, can we not by exercising that portion of the brain wherein the stammerer is deficient, improve and strengthen it to a degree sufficient to give the will absolute control over the organs of respiration ? For illustration or example, suppose we wish to execute costal breathing. In costal breathing we direct the effort of the mind to the muscles of the sides and by forcing the same to obey the dictates of the will we force them out and allow them to again contract, al- * stammering originates in the brain, see footnote page 27. -89-. THE ORIGIN AND TREAT-MENT OP STAMMERING ways, of course, aiding this performance by means of the pressure of the air within, which we have in the meantime inhaled for this purpose. We repeat this ex- ercise again and again and in so doing not only exercise the costal muscles of the body, but at the same time are also educating the mind to control muscle action. We proceed to other forms of breathing and find in dorsal breathing the will commands the muscles of the back, in chest breathing the muscles of the chest re- spond to the dictates of the mind. In diaphragmatic breathing we find the diaphragmatic muscle obeys, and hence while the muscles of respiration are being exer- cised, that which gives the command is also being ex- ercised. In stammering we find as a result of certain existing circumstances the muscles of respiration refuse to obey the dictates of the mind. The will is insuffi- cient; the harmony and co-ordination of the functions and organs concerned in speech production is disturbed and we falter or stumble, but if we educate the mind to control these muscles we find always a ready response to our desires. This is the relation of breathing exer- cises to a possible cure for stammering. Another incalculable benefit to be derived from a good system of breathing exercises is the development it gives to the whole body. But you say — what benefit can that afford me ? What bearing has that upon a possible cure for my stammering? Would you believe it that nearly everything you do has either a beneficial or deleterious effect upon your talking ? One stammerer says : I stam- mer worse when I am suffering from indigestion ; an- other argues that he suffers worse from the loss of sleep ; —90— THE ORIGIN AND TREATMENT OF STAMMERING another claims that his greatest difficulty comes from cold in the head ; another has spasms when brought into contact with strangers ; another grows worse from the use of tobacco, and thus I could tell you of a thou- sand and one or more persons, all of whom suffer worse from this, that, or the other thing. They do not seem to attribute it all to one parent cause. When you observe a result you may always rest as- sured there is a cause, and in this cause (the disturbance of the nerve centers of the body) lies the great unhid- den law that rules supreme. Anything that upsets the equilibrium of control should be carefully guarded against. He who stammers worse when suffering from indigestion must learn that the whole nervous system of the body is affected by a deranged condition of the stomach and that his excessive difficulty in speaking under such cir- cumstances is but natural, because that which affects the nerves affects also the fluency of his speech. He who overindulges himself in natural or unnatural excitement must pay the penalty in his talking — be- cause just as sure as the night follows the day, so also does stammering follow a disturbance or agitation of the nerve centers. He who stammers worse when suffering from the effects of a cold must also learn that he is suf- fering from a disturbance of the nerves. This has been not only my personal experience, but is largely based upon my observation in hundreds of other cases. The same law that metes out suffering to the stam- merer who would disobey its rulings also crowns with laurels of success him who will build up and strengthen his body. Thus, if it can be shown that breathing exer- — 91 — THE ORIGIN AND TREATMENT OF STAMMERING cises are beneficial for this purpose, it stands us well in hand to add them to our curriculum of studies. Another beneficial result of the breathing exercise for the stam- merer is the additional capacity it gives him for the re- tention of breath. Breathing exercises also give an upright carriage to the body, develop the chest, and keep the blood in active circulation. In short, they are bene- ficial to the whole organism, and while they cannot of themselves effect a cure for stammering, they neverthe- less serve as an auxiliary and aid us in our work. SLEEP The New Year's, 1898, number of the Youth's Com- panion, in an article entitled "Gladstone at Eighty- eight," attributes the wonderful enduring faculties of this well-known statesman to his capacity for sleep and short naps. During his whole Hfe it is said that he methodic- ally found time for rest as well as work, and thus, unlike the majority of Americans of the same age, Gladstone at that time was well preserved and in possession of all his faculties. Sleep is curative. Sleep is restful. Every stammer- ing man, woman, and child should observe methodical and regular hours for sleep. In cases of intermittent stammering, where the severity of the afBiction alternates in ratio with the physical condition of the sufferer, sleep, above all things, should be earnestly courted. Rest is oftentimes as beneficial as sleep. A half hour's rest or sleep before dinner will serve to strengthen the nerves and refresh the body as nothing else can. Every person — 92 — THE ORIGIN AND TREATMENT OF STAMMERING who suffers from stammering should sleep from eight to ten hours in every twenty-four. Do not oversleep, but sleep sufficiently. Too much sleep is as harmful as too little sleep. A good plan to pursue, if possible, is to sleep whenever you feel sleepy, except after eating heartily. Never sleep on a full stomach. You can neither sleep well nor will your food digest well. Always rest for a time after eating, but avoid sleep until your food is well under the process of digestion. Dr. Felix L. Oswald, in an article entitled, "The Curative Power of Sleep," written for Health Culture, New York, says : ** Brain-work succeeds best while the activity of the animal organism is reduced to an indispensable mini- mum. The mind is never clearer than early in the morn- ing, when the work of digestion is finished ; and for similar reasons digestion proceeds most prosperously while the brain is at rest. A correspondent of mine, who is subject to attacks of spasmodic asthma, often passes a whole afternoon on suburban trolley cars, knowing from experience that the rocking motion and the sight of monotonous streets are apt to result in cat-naps, and that the shortest nap of that sort is sufficient to break the spell of the dyspnoea — the distressing difficulty to draw a full breath of life-air. A mere cat-nap is also sufficient to relieve sick head- ache, dizziness, spasms of colic, and neuralgia ; and pro- tracted slumber — five or six hours of dreamless sleep — has saved more than one life that could not have been as much as respited by all the drugs mentioned in Bar- tholomew's "Handbook of Therapeutics." Chronic — 93 — THE ORIGIN AND TREATMENT OF STAMMERING diarrhoea has been known to yield to that specific, and in many kinds of fevers, too, everything is gained if the patient can be helped to a few hours of deep slumber without the use of narcotics. Monotonous work, pur- posely continued to the verge of fatigue, may help to relieve insomnia, and in obstinate cases the application of warm winding sheets to the feet and of cool cataplasms to the head will promote the same purpose by alleviat- ing the engorgement of the cerebral blood-vessels. Opiates only mock the patient with the appearance of relief, and, like brandy in the r6le of a dyspepsia cure, frequently result in an aggravation of the trouble. Lau- danum paralyzes the digestive organs, and not only fails to reproduce the conditions of natural slumber, but goads the brain into fever-dreams, more permanently injurious than sleeplessness. Anne Payson Call, in ''Power Through Repose," speaking of "Rest and Sleep," says: ''ReaHzing fully that sleep is meant for rest, that the only gain is rest, and that new power for use comes in consequence — how absurd it seems that we do not abandon ourselves completely to gaining all that nature would give us through sleep." Sleep is quieting to the nerves, soothing to the brain, and nourishing to the body. Undeniable as this is, can- not the reader easily understand that sleep is helpful to the stammerer. The stammerer, generally speaking, is nervous, and owing to his continued fear of stammering becomes mentally fatigued. His thoughts course rap- idly through his brain, even faster than he can phys- ically produce them. Motive power, when generated, — 94 — THE ORIGIN AND TREATMENT OF STAMMERING is oftentimes misdirected, and in consequence he ages quickly. Canon Kingsley has said : " The stammerer's life is full of misery, and necessarily a short one by reason of the mental depression and misdirection of vital energy which is induced thereby." Sleep cannot, by any means, effect a cure in any case of stammering. The point I wish to emphasize is this : that loss of sleep and irregular hours will aggra- vate and make worse any case of stammering. I wish to add, also, that plenty of sleep, with regu- lar hours, will, by quieting the nerves and resting the brain and body, make possible for successful treatment cases of stammering that might otherwise prove diffi- cult to cure. MORALITY There is no doubt but that morality obtains a wide influence for good in the treatment and cure of stammer- ing. We have heard much about the physical treatment of stammering, and yet, important as it is, there has been but little written about the moral treatment of this awful affliction. I do not assume that morality and purity in living can in any case effect a cure for stammering. My claim is that it makes favorable for successful treatment a condition which would otherwise prove unfavorable. Fortunately, I have known of very few stammerers im- morally inclined. On the contrary, the affliction appears to exert a restraining influence over its victim, and in the same manner that it deprives him socially from the en- — 95 — THE ORIGIN AND TREATMENT OF STAMMERING joyment of the pleasures of life it also holds him in check from falling into the pitfalls of ruin. There are without doubt exceptions to this, since I have known of one or two stammerers who were decidedly immoral characters. My experience, however, from contact with large num- bers of persons afflicted with stammering, bears me out in reaffirming that the large majority of stammerers are of the moral type. There is good and bad in everything and everywhere, and oftentimes the latter element pre- dominates, but fortunate as is the case among stammerers the majority of them are, if not strictly moral, morally inclined. This fact is largely in favor of the stammerer, so far as the possibility of a cure is concerned, because if the order of things in this respect were reversed it would in a measure lessen the chances for recovery. The mor- ally inclined stammerer is generally more susceptible to treatment than the stammerer who is not morally incHned. With a mind full of corrupt thoughts, a mouth full of evil sayings, and a body full of languor or disease, we have many obstacles to surmount before entirely satisfactory results can be accomplished. On the other hand, a mind filled with goodness and virtue, a clear conscience, and a healthy body make successful treatment both probable and possible. The stammerer who would make for him- self a condition most favorable for an absolute cure of his affliction should at once set about to live a hfe of chastity and purity. Let him engage his mind with wholesome hterature, his body with healthful exercise, and let him choose his companions with as much care as he would choose a life partner. Companionship has more to do with moral living than we would suppose. Every im- -96— THE ORIGIN AND TREATMENT OF STAMMERING pression received is one either for good or evil, and thus one evil companion will readily overthrow the very thing you are trying to establish, while a companion of good morals will strengthen resolutions and build up character. To prepare yourself for the most favorable results for treatment cleanse your mind of every impure thought and keep it constantly cleansed and pure. Avoid obscene language, burlesque or other objectionable plays or thea- ters, the use of tobacco in every form ; also avoid the use of liquor, tea, coffee, and above all the poisonous ciga- rette. Avoid also all kinds of vice and the indulgence in any pleasure that exhausts the vitality. Take plenty of physical exercise, eat wholesome food, retire early, sleep on a good,comfortable bed, bathe often, and live well. If you will follow the plan I have here laid out, you will not only enhance the probability of a cure for your stammer- ing, but you will also elevate yourself in your own esti- mation and in the estimation of all other men. DIET There is more benefit to be gained from diet re- strictions than the stammerer would at first suppose. Many persons who stammer are equally as unable to control their appetite as their speech. Naturally of an active temperament and a nervous disposition they fall into the rut of doing everything quickly and without regularity. Probably one of the worst evils, aside from that of stammering, wrought by this practice or habit of doing things quickly, is that of rapid eating and overeating. It is also equally as harmful to the 7 -97 — THE ORIGIN AND TREATMENT OF STAMMERING Stammerer to eat food that is highly seasoned. He should avoid the use of spices or condiments in every form. Eat and drink nothing that contains more stimulus than nourishment. Eat nothing animal or vegetable that has not obtained maturity to reproduce itself under ordinary circumstances. Use neither tea nor coffee nor alcoholic liquors ; avoid fatty substances and eat but little, if anything, that contains lard. Eat slowly and drink nothing while you have food in your mouth. Indeed, try to do everything moderately, and keep down all excitement of either body or mind. Cultivate a cheerful disposition and an agreeable state of mind. Cultivate none but agreeable feeling toward all. Be regular as possible in your habits, whether of eating, drinking, sleeping, or exercise, and do all things decently and in order. A derangement of the stomach means a derangement of the nervous system, which in turn aggravates your natural weaknesses. Nourish your body with wholesome food, and eat only such things as can be well digested. Indigestion is one of the aggravating evils of stammering. Apply the rules here laid down, and notice the improvement in your general health as well as in your talking. ^ 98- STAMMERING PRACTICALLY, THEORETICALLY l,ecture delivered before the members of the Detroit Academy of Medicine, June 25, 1895. My experience from contact with the stammerer convinces me that the difficulty is scarcely, if ever, manifested in two persons in exactly the same manner. I have also learned that the conditions under which stammerers experience the greatest trouble are by no means the same. There appears to be a wide difference of opinion regarding the definition and origin of this malady. It is not my intention, however, to enter into and discuss different authorities and criticise their definitions, but to outline as clearly as possible the cause of the stam- merer's difficulty and practically demonstrate to you my mode of treatment. I have frequently been asked the questions, "To what do you attribute stammering?" "What is the difference between stammering and stuttering?" To the public there would seem to be but little difference, ^99 — THE ORIGIN AND TREATMENT OF STAMMERING and even the close observer, unless thoroughly ac- quainted with the peculiarities of this affliction, might easily be led astray in his conclusions. Without going into detail of explanation, I will say that stammering is principally manifested in the articu- lating organs. Stuttering, on the other hand, is largely confined to the organs of respiration and vocalization. We have often heard it said that persons who stammer in conversation can sing without difficulty. This is generally the case, but not always. I occasionally come in contact with persons who experience the same impediment in singing as in talking. Their efforts to articulate certain syllables in singing meet with the same hindrance as is manifested in their conversation. Such cases, however, are rare. All movements of the human body are brought about by the action of muscles that are attached to movable apparatuses and are made to operate through the medium of the nerves. Without the proper co-operation of the muscles, it is impossible to accomplish anything. Thoughts originate in the brain, — the brain acts upon the nerves, — the nerves act upon the muscles, — the muscles act upon the bones, — and only after this process are we able to under- take any act. If the process of action is one of harmony, the act will be successfully accomplished. If, however, after the origin of thought there is an inability to accomplish or perform any ordinary human action, the deficiency is due to a lack of co-ordination. This lack of co-ordination of action, when spoken of in connection with or as related to the production of words, is the source from which originates or develops all forms of THE ORIGIN AND TREATMENT OF STAMMERING abnormal speech. The humiliation of stammering, the desire to speak fluently, and the fear that he may not be able to do so, keeps the stammerer in a state of con- stant mental emotion. It is owing to this condition of continued fear that we have associated with stammering so much nervousness. With the aid of a numberof my pupils who are present with us this evening I will endeavor to practically demon- strate to you, as far as possible, my mode of treatment.* My manner of dealing with the stammerer is prob- ably different to any that has heretofore been intro- duced, my own experience as a sufferer having given me a keener knowledge of the stammerer's nature than I could possibly otherwise have gained. The first pupil I will introduce to you this evening appeared before you at your last regular meeting, and, as you remember, was utterly unable to read or speak three connected words. He applied to me personally for treatment, and was obliged to indicate by signs and by writing his wishes. The contortions of his face, you will remember, were most painful. He will address you to-night, and I want you to note carefully his complete change. I will also introduce to you a pupil who has been under my treatment but three weeks, who stammered continually for many years, and who will tell you in a fluent and conversant manner of his remarkable cure. *A number of pupils under treatment expressed their desire to attend this lecture and asked permission to submit themselves for examination to the members of the Detroit Academy of Medicine as evidence of the thor- oughness of the treament they had undergone. — lOI — THE ORIGIN AND TREATMENT OF STAMMERING I have also with me a pupil who has been under other treatments at several different periods during his life, from which he says he received no perceptible benefit, and who will, I am sure, be pleased to relate to you some of his former experiences. You may talk to these gentlemen and to my other pupils with me this evening, and I do not believe any of them will stam- mer, notwithstanding they are all here in Detroit for treatment, some of them having come long distances to attend my Institute. Before asking the gentlemen to address you I will endeavor to demonstrate (as far as the time allotted for this lecture will allow) the mode of treatment I follow in my school from day to day, and from which we have been able to obtain the results you see manifested here before you. I can, of course, give you but an idea of the work that is carried on daily in my Institution, owing to the fact that I am obliged to demonstrate within an hour's time what usually requires from three to eight weeks to accomplish. * From four to five hours each day we exercise our pupils after this manner. Vocal and physical exercises are also introduced, and generally by a series of exer- cises founded on an educational basis, of discipHning the pupil to do exactly as he is told, he gradually gains perfect confidence and freedom of speech. *A half hour was, at this point of the lecture, devoted to the practical demonstration of the I^ewis Phono-Metric Method of treatment, used largely in effecting a cure. — 102 — THE ORIGIN AND TREATMENT OF STAMMERING At first the instruction to the pupil is usually pri- vate, and after he has made sufficient progress to war- rant it he is obliged to perform before a portion of the class what he has already done in my presence. If he can do this successfully, other pupils are introduced, and he is placed under the most embarrassing condi- tions, made to read, to converse, to deliver impromptu speeches, is cross-questioned, and the most severe tests applied. If with perfect confidence he proves himself capable to fully stand these tests, he is then permitted for a few days to talk at leisure to myself or to the other pupils, asking any questions he desires or he may enter into general conversation. If, after this time, we find that he does not stammer, he is permitted to join our question-asking expedition and is allowed to talk to any one or every one — the* more the better. It is impossible to tell definitely when he enters the length of time any pupil will require for treatment. It largely depends upon his application to his work and his aptitude and comprehension. The average person, however, has been obliged to remain from three to six weeks. Author's Notet^The' reader must not infer from the above that pupils attending our Institute are in any manner, asked to submit themselves to criticism either in a public way or otherwise. On the contrary, we are extremely careful to maintain the utmost privacy for those who place them- selves under our treatment and care. We never mention the names of our pupils without permission, and, when desired, the strictest confidence and secrecy of corresjHjndence or attendance is preserved. As already stated, the gentlemen who attended this lecture expressed their desire to be present, knowing that they would be called upon to address the members of the society. Notwithstanding this caution they decided to attend in a body and were highly complimented on all sides for the success of their undertaking. — 103 — CAUSE AND CURE OF SPEECH DEFECTS AND THE Conditions That Render Stammering Curable A paper read before the Convention of the National Association of Elocution- ists of America, held at Detroit, Mich., 1896, June 24 to July 3. I KNOW of no other subject demanding the same consideration and attention upon which so little has been written and said as the affliction of stammering. It has occurred to me that more has been accomplished for the advancement of the study of elocution during the past five years than for the cause of the stammerer during the whole of the bygone century. While relief for almost every other known infirmity has been' carefully sought after, the cause of the stammerer has been sadly neglected. Schools for the deaf and dumb, institutes for the blind, homes for sick and friendless children, homes for the aged and infirm, asylums for the insane and incur- able, and many other such public institutions mark the charitable spirit of our country, while the affliction of stammering receives only a passing recognition. — 104 — THE ORIGIN AND TREATMENT OF STAMMERING My own experience, having myself stammered for more than twenty years, together with a careful study of the subject and contact with a great number of persons who stammer, convinces me that a great majority of persons who are thus afflicted are themselves as ignorant of the real nature of their malady as are the persons with whom they come in contact. They know they stammer, but further than this, concerning the cause and necessary means of correction of the evil, the great ma- jority of them know absolutely nothing. Before much can be accomplished along the line of advancing the cause of the stammerer, some radical changes will require to be effected. The stammerer will require to be educated to an appreciation of the neces- sary means of correction of his difficulty and the public in general enlightened regarding his neglected condition. I feel it unnecessary to speak in condemnation of the crude surgical practices for the relief of stammering re- •sorted to during the early part of the present century. Those present who know the history of the art and science of treating stammering are aware of the awful results of which I speak. I shall not attempt to give you a history of these blunders. They were too many in number, would fill too many volumes, and would require too much time to here explain. They covered a period dating from the early history of Europe down to 1870, during which time the poor stammerer was butchered and tricked in every imaginable way. By those who have given serious thought and study to the subject, it is conceded that stammering is of men- tal origin. With persons who stammer there seems to — 105 — THE ORIGIN AND TREATMENT OF STAMMERING exist in the portion of the brain which governs and con- trols the motions requisite for the production of speech a difference of brain fibre from that of the ordinary in- dividual. The difference does not appear as one of structure, but of sensibility. This idiosyncrasy exposes the brain of the stammerer to be most easily disarranged and the organs co-operating thrown into spasmodic action by the ordinary mental desire to speak. In other words, there seems to be a lack of co-ordination and of harmonious action between thought and its transmission and conversion into articulate speech. Thoughts of the brain arising either from immediate sensation or other- wise are carried along through a succession of channels before they can be audibly expressed. Few of us, unless we have given careful study to the subject, know just what this process of transmission consists of. To better illustrate, let us imagine the transmission of thought from the brain and its conversion to expressed words and ideas a chain consisting of several links. The first link represents the systematic arrangement for produc- tion of thoughts and ideas that originate in the brain through our immediate sensations, or which take their origin in an abstract manner. The second link represents a determination or desire of the will to give expression to thought. — io6 — THE ORIGIN AND TREATMENT OF STAMMERING The third Hnk represents a generating influence of the will that moves to action any portion of the body. For the purpose of illustration I have designated this influence ** Motive Power." The fourth link represents the action of articulate speech. We have before us in the four links of this chain the process of transmission of thought to its conversion into audible expression, and a complete analysis of speech, which, I trust, will better enable us to discover the stam- merer's defect. It will now require an investigation and examination on our part of the different links which make up this chain to find the point at which the functions concerned cease to harmonize. As long as the process of transmis- sion is harmonious the results will be most satisfactory. It is only when the organs concerned in the production of speech do not act in harmony that we hesitate or stammer. Let us turn our attention to the first link of the chain before us. Is the elaboration of thought and its arrange- ment for production in the brain of the stammerer un- systematic ? Do we find this to be true ? If true, the stammerer, intellectually speaking, would not only be weak-minded, but would also be lacking of intelHgence. The fact that many of the brightest men the world has known have stammered would appear as evidence against such a conclusion, and I think any further argu- ment on this point is unnecessary. I think it is generally admitted that the stammerer is not weak of intellect, but on the contrary, many persons who stammer are superior — 107 — THE ORIGIN AND TREATMENT OF STAMMERING in this respect to some persons who are gifted with per- fect fluency. From an examination of the second Hnk it would appear that there can be nothing lacking in the desire of the stammerer to express himself. If so, the defect must amount to either an excessive or deficient energy, resulting in an inability to give physical action to internal thought. If the difficulty of stammering were due to a defect at this point, we would find that, as well as the organs of speech, other organs of the body would fail to respond to our desire. Again, let us consider the case of the infant. Take, for illustration, the child who has inherited the original defect of the stammerer. It, as well as the adult, can only make known its wants by means of physical action, and if the defect of stammering were due to an excessive or deficient mental desire, we would find this child, be- fore speech was complete, would be not only wholly un- able to express itself, but would betray all the symptoms of the stammerer. It has been found, however, that such children do not betray their malady until a more complex action is required of them than the mere act of desiring. This, to me, is conclusive evidence that the difficulty of stammering is not attributable to any deficiency at the point under consideration. Before examining the third link of our chain let us proceed to consider the fourth. I believe stammering to be of more obscure origin than is generally believed. True, the outward manifestations to the observer are wholly confined to the organs of speech and, at first thought, it would appear that the cause of the difficulty — io8 — THE ORIGIN AND TREATMENT OF STAMMERING might be attributable to wrongly formed speaking organs. If stammering were due to an organic defect of the organs of speech we would find persons who are thus afflicted would always have exactly the same diffi- culty on the same words and under the same conditions. We find, on the contrary, however, that persons who stammer are at times able to converse in a perfectly fluent manner without the least hesitation, while at other times they are unable to speak three connected words or to raise their voices to make an audible whisper. I am willing to admit that persons who stammer are as liable to organic defect of the organs of speech as are persons who are not afflicted, but do not beheve that the percentage of persons who suffer from organic defect of the speaking organs is any larger among stammerers than among other persons not addicted to stammering. Furthermore, I have never found, in a single case of stammering, the least defect in the organs of articulation. I therefore conclude that the action of speech itself is, with the stammerer, perfect and complete. We have now examined all but the third link of our chain, and having found nothing to indicate the origin of the stammerer's difficulty, let us proceed to examine the third. This link joins mental desire with physical action and would appear as the point where the current of thought is connected with the movable apparatus of articulate speech. Up to this point the process of trans- mission is but mental. Here the current of thought is connected with the dynamo of human mechanism, and like a flash mental desire is transmitted and transformed — 109 — THE ORIGIN AND TREATMENT OF STAMMERING into moving, living action. This point of contact may be the source of all forms of abnormal speech. The mental energy of the will fails to generate to action the required stimulus of mind and body necessary to the proper co-ordination and harmony of the functions con- cerned in the proper production of perfect speech. The lack of harmony thereby occasioned results in stammer- ing and, as previously stated, the point of contact would appear as the real source and origin of the stammerer's difficulty. The unsuccessful efforts of many who have en- deavored to treat the stammerer I attribute to unfavor- able conditions. With favorable conditions and proper treatment any case of stammering, no matter how se- vere, can be successfully treated. Let us consider for a moment the conditions favor- able to a perfect cure : First, any treatment, to successfully overcome stam- mering, will require to establish a foundation upon which to build. Second, this foundation can be explained as the basis from which the child, during earhest infancy, evolves the proper manner of talking. To establish such a foundation means a return to the fundamental principles of breath and tone production, with a well- directed force of will against the mental influences of stammering and the unnatural conditions that have arisen. The third condition to a successful treatment will require an instructor who, from a personal experience of stammering, can appreciate the feelings of the stam- THE ORIGIN AND TREATMENT OF STAMMERING merer and know the trend of the mental influences that act in discord. Such a person with a well-directed force of will power constantly exerted in the right direc- tion can successfully direct the stammerer to a proper deliberation of action. The fourth condition to a successful treatment will require for the stammerer a home life surrounded with moral and persuasive influences, directly under the care and watchfulness of his instructor, where, from day to day during treatment, the necessary care can be easily exerted. The sixth condition to a favorable treatment will re- quire that the stammerer may be surrounded with a number of others who are similarly afflicted, that he may constantly be reminded by them of the grave im- portance of careful attention to training. The seventh condition to a successful treatment is proper food and nourishment for the stammerer. His changes of diet, hour for retiring, and habit of stimu- lants will require to be carefully restricted. These conditions earnestly sought after and strictly adhered to will make favorable for successful treatment the most severe cases of stammering you can possibly imagine. — Ill — INSTITUTIONAL AND HOME TREATMENT There are many diversities of opinion as to what constitutes a good treatment for the cure of stammering. To me a good treatment for the cure of stammering means much. To others it may mean the same, but their way of looking at the matter and my judgment of the affair may be entirely different. Thus I will endeavor to make plain my views and will tell what practical ex- perience has taught me to be, from all points considered, a good method of cure. Feeling that the influence of both the institute and the home are necessary in accomplishing the cure, I shall endeavor to point out to my reader a place for both, and throughout my discussion will try and make clear my ideas of the merits of each. The fact that I can count on the fingers of one hand but few institutes for the cure of stammering (within the last quarter of a century) that have proved successful, is evidence that there is a lack in management somewhere. I know of more than a score that have started apparently under the most favorable circumstances and have subsequently fallen by the way- side. Who is responsible for this ? Was it a lack on the part of the instructor in his ability to effect the cure, or THE ORIGIN AND TREATMENT OF STAMMERING . was failure due to lack of business management? In the majority of cases both causes were responsible for failure. The first requisite necessary in successfully con- ducting an institution for the cure of stammering is an ability to effect the cure. I am satisfied also that no per- son excepting one who has himself tasted of this cup of galling bitterness is in a position to understand the feel- ings and condition of the stammerer. The circumstance that a person can cure a single case of stammering, or in fact that he can cure a number of cases, is no evidence that he could conduct successfully an institution where large numbers of persons thus afflicted are expected to congregate for the purpose of obtaining relief. To suc- cessfully conduct an institution of this kind it requires something more than an ability to cure, which is, however, as I have already said, an important element to success, in fact, the most important. Institutions must be con- ducted on a large scale to insure success. A small mer- cantile business will sometimes pay better returns for the money invested than larger concerns of a like nature, but a small institution for the cure of stammering run in a small way is nothing. Everything in and about a stammering school must have attention to insure good results. In the first place the system used to effect the cure is important. Whatever the system may be it must be complete. It requires on the part of the teacher a knowledge of all systems, without which and without the skill of an adept in applying them the results looked for may prove disappointing. Surprising as it may ap- pear to one unacquainted with this study, more depends 8 —113 — THE ORIGIN AND TREATMENT OF STAMMERING Upon the thoroughness in applying certain principles than in the methods themselves. To know a thing and to do it are two entirely different things, and thus it re- quires not only familiarity with certain rules, but also that these rules and principles must be properly appHed and carried out. There must be method in everything. Even as a large department store, such as Wanamaker's of Phila- delphia, or the Siegel Cooper Co. of Chicago, could not succeed without method, neither can an institution for the cure of stammering. The business methods of an in- stitution of this kind are as important to its success as its methods of cure. Correspondence should be well cared for. Letters carefully filed away; answers as carefully copied, and all correspondence kept as confidential as a sacred trust. A proper office system throughout should be maintained. A separate advertising department established, where all Hterature, pamphlets, circulars, and magazine advertising is properly taken care of. Bills due should be paid at once, in order to insure the financial rating or standing of the institution. Receipts should be made out and given to all persons paying money into the institution, however large or small, and the utmost economy practiced at all times. One reason, I think, that so many institutions for the cure of stammering have failed is, because of their many broken and unfulfilled promises. They picture things in an untrue light and gild their phrases with the warm- est coloring. This is a great mistake. We see the same principles carried out in every-day life. Every daily paper we read is filled with untruths. The advertise- — 114 — THE ORIGIN AND TREATMENT OF STAMMERING ments of the majority of stores, many of them consid- ered reliable, are full of untruths. '' Bankrupt Sales," *' Going Out of Business," " One Dollar a Yard Goods for Fifty Cents," "Dissolution of Partnership Sales," and what not — all to deceive the public. Why not the truth ? Isn't it better in the end ? Of course, and so it would have been better for many of those institutions, now obliterated and dead, had they not made so many promises which they knew they nor anybody else could not fulfill. In looking after their own pecuniary interests many of those institutions that have failed entirely lost sight of the pupils* welfare. Their object appeared to be to get all the money they could and give as little work for it in return as possible. The pupils' interest should be considered first, in which way is the only way of serv- ing the best interests of the institution. The fact of the matter is, the pupil makes the institution, and with- out that support which he gives, no institution can exist without loss. Here is a critical point, however, as the teacher may ( overambitious to serve his pupil and at the same time himself) indulge his pupil in liberties which he should not have, with the fear that his order to desist will mean a separation of friendship. I know of but one way to overcome. this obstacle. Teach the pupil to know that duty comes first. That all other issues to his cure are secondary and that you prefer his ill will and respectTather than his good will without it. Obedience is the first law of order and should be made infallible, as a principle, with pupils in their duty to the instructor. -115- THE ORIGIN AND TREATMENT OF STAMMERING Let the teacher establish a fixed rule in dealing with pupils and never deviate from a principle which experi- ence has taught him is best. Accept suggestions, but do not accept dictation from any pupil as to the treat- ment best adapted for his particular case. He comes not to instruct, but to learn ; not as a teacher, but as a pupil, and as such should be taught to obey. Let the teacher ask kindly that his instructions shall be fulfilled, and carry himself with such dignity as will maintain the respect and confidence of his pupils. If the pupil openly disobeys, let the teacher demand obedience, and if necessary exact it. The majority of pupils, however, are ever ready to obey, as in obedience to in- structions is embodied the elements of the cure. In considering the requisites of the institution, it can be authoritatively stated that the influences of the home life are absolutely necessary to the best interests of both teacher and pupil. In fact, I consider that at least 25 per cent, of the value of treatment in effecting the cure is in some instances due entirely to the influ- ences for good which all pupils under treatment for stammering should have cast around them. The care- fully guarded moral life of the ideal home should be made a permanent fixture of the institution. In the conduct of institutions for the cure of stam- mering this important feature has not been taken into consideration, and for this reason, if from no other, such schools have been short lived. To insure success the management of the institution should provide for its pupils a home equipped with all modern conven- iences, customary to modern ways of Hving. Not only — 116 — THE ORIGIN AND TREATMENT OF STAMMERING in this respect should the home be provided for, as many a house equipped in the matter of modern con- veniences is anything but a home. In speaking of the home, I refer more particularly to the influences and surroundings rather than to equipment and furnishing, which, however, are important if not indispensable. Everything in and about the home in connection with an institution for the cure of stammering should be kept scrupulously clean, neat, and cheerful. Read- ing rooms as well as a library should be provided for pupils, with plenty of wholesome literature. All the popular magazines of the day, such as the Century, Harper's, Scribner's, Munsey's, the Ladies* Home Jour- nal, the Youth's Companion and several dozen other papers of this class, as well as religious papers of high character, should be placed at the disposal of the pupils of the institute. The establishment of a home of this character, how- ever, in connection with an institution for the cure of stammering is not as easy a matter as it would appear. It costs thousands of dollars, but it means much to the stammerer, as it adds considerably to the value of his treatment. Parlors should be provided with pianos, as well as comfortable sitting chairs for retirement and ease, and every pupil of the institution, no matter what his former sphere of life has been, should be made to feel perfectly welcome to every portion of the home. Deportment and gentlemanly conduct should be made the only obligation in return for these many advantages, and with a carefully guarded life on the part of those who — ii*? — THE ORIGIN AND TREATMENT OF STAMMERING have charge of the home, the highest degree of success may be expected. While the institution owes the pupil a duty almost equal to an avowed obligation, the pupil in return owes the institution a duty equally as important. It is the part of the teacher to instruct, to encourage, to enthuse, and, if necessary, to exact or demand. It is the part of the pupil to obey, and not only to obey, but to do more than obey — to exert himself in his own behalf. There are many kinds of salaried employees — of which two distinct classes have always been apparent to the writer. That class of persons who work only for their own interests and do exactly what is expected of them for a fixed sum per day or per week. That class who in trying to serve their own interests try to serve also their employer's interest, and who show by their efforts that they are doing more than is expected of them. The former class always work for a fixed salary, which is never advanced. They are paid for exactly what they do, and they do exactly what they are paid for. The latter class generally find their way to the top, as the employer realizing the fact that they are doing more work than they are being paid for, will, if just, advance them accordingly. This same idea appears to prevail among persons under treatment for stammering. Some pupils work only to serve their own interests. They obey, but create no originality. They do exactly the amount of work demanded, but nothing more. The other class is that of pupils who work not only for their own interests, but also for the interests of their — ii8 — THE ORIGIN AND TREATMENT OF STAMMERING fellow sufferers. They make an effort of their own. They put forth a determination into their work that generates a like determination in others. They create an originality and do many things not absolutely re- quired of them, but which serve to advance them in their work. In this they are wise, as it is only in serving the best interest of the institution and of his fellow sufferer that the stammerer will succeed in serving best his own interest. There is another class, and a most important one to the institution, as no institution can long succeed if ham- pered by its influence. This class is one of persons who are disinterested in their own cure. They come into the institution because their parents or friends want them cured. They feel no humiliation over their infirmity. They boast that it is their own business if they stammer, and say if other persons do not like their style of talking they do not have to. Such persons should be barred from treatment, as their presence is always harmful to others, and, besides, effort to cure them generally results in failure. They are as indifferent to treatment as they are to the opinions of those whom they torment with their stammering. To succeed in its efforts, the institution should en- deavor to instill into the life of every patient a determi- nation to succeed. No such word as ** failure" should be permitted. Stammerers who come into the institute, not knowing the importance that attaches to willingness to obey, and personal effort on the part of the pupil should be taught the importance of these factors at the beginning. — 119— THE ORIGIN AND TREATMENT OF STAMMERING Those who put forth effort of their own and obey to the letter should be encouraged to the utmost, while those who are disinterested in their cure should not be permitted to enter. Rigid discipline in»treatment, with attention to detail by the pupil in following out instructions, together with carefulness on the part of the management in watching the progress of its pupils, will, if the above suggestions are carefully observed, add largely to the success of any institution for the cure of stammering. The advantages of the home life in connection with the institution are shown in the benefit derived by pupils through association. In a school of this kind the co- operation of the pupil with the teacher is absolutely essential. He should be taught also to manifest an interest in others. In this way the subject becomes interesting to him. He soon learns to regard the cure as a study, and it is oftentimes surprising with what earnestness he will apply himself to solve the problem. Mr. A becomes interested in the phenomenon o\ Mr. B's case, while Mr. B is equally interested in study- ing the peculiarities of Mr. A's case, and so on through- out an entire class of ninety to a hundred pupils. Has the reader ever stopped to think what it means to have this many stammerers all collected together under one roof ; all living together, eating together, and working to- gether ? It means a great work, I can assure you ; but when these ninety to a hundred persons are constantly changing places, new ones coming and old ones going, it means in the course of a year many hundred patients. That all these persons should learn to co-operate with — 120 — THE ORIGIN AND TREATMENT OF STAMMERING the teacher is one of the important elements to success ; but that they should also be brought into associa- tion, one with the other for each other's benefit, that they should in fact each strive to help the other, is a still greater element to success, and one of the most im- portant elements of the cure. In this way, in addition to the regular teaching staff of the school, every pupil has constantly from ninety to a hundred instructors, all interested in his cure and anxious to have him succeed. Another advantage to be derived from the home life in the institution is that of making the pupil feel satisfied and cheerful. Naturally sensitive over his affliction, he does not care to associate with persons who have no sympathy for him. He does not ask for sympathy, yet dislikes ridicule. Thus by bringing him into the home where he is constantly in association with others who are similarly afflicted, he is not exposed to the heart- lessness of unkind persons, which he might otherwise fall in with. There should be system in the home life of the school as well as in the method of instruction. In this the advantages of a home for the pupil are without question of great value. He can he most carefully watched, and is at all times directly under the observa- tion of the faculty. His hour of retirement, his daily exercise, his diet, as well as his other habits, can all be carefully regulated. In this respect, if in no other, the advantages of the home are without question of more than real value to the pupil under treatment. In a word, the home provided for the pupil is as im- portant in accomplishing the cure as is the method of THE ORIGIN AND TREATMENT OF STAMMERING instruction. The latter should be thorough, while the former should be adapted especially for comfort, con- venience, and accommodation. It should contribute to make the life of the stammerer a cheerful one ; it should surround him with wholesome and moral influences ; it should in fact be a Christian home in every sense of the word, and thus, while aiding in accomplishing the cure, it will also serve a two-fold purpose, that of adding to the life and character of the pupil. When you have made up your mind to enter an in- stitution for the cure of stammering, go in with all con- fidence in your instructor, belief in the cure, and a firm determination to win. I make this suggestion for two reasons: I have observed that the degree of success with which the pupil meets is always in direct ratio to his belief. I have also observed that pupils without confidence in their instructor lack also confidence in their cure. Fortunately, I have had but few cases of this latter kind to contend with, as the majority of persons suffering from stammeringwithwhom I have come in per- sonal contact were firm believers in the cure. However, I have occasionally met one who, owing either to former failure or to general skepticism, disbelieved in any method of cure, but who for the sake of experiment was willing to go in on a speculative basis. This is poor policy, and sometimes proves an expensive experiment in the end. It costs the same for treatment whether you be- lieve or disbelieve, whether you have confidence in your instructor or whether you lack confidence in him, and the results are always more gratifying to those who be- lieve. It is the hardest work in the world for a physi- — 122 — THE ORIGIN AND TREATMENT OF STAMMERING cian to raise from a sick bed a patient who believes he is going to die. It is equally hard for the teacher to cure his pupil of stammering unless the pupil places confidence in the instruction. This class of disbelievers is detrimental to the best interests of both the institu- tion and its pupils, and often dampens the ardor of a whole school. Many of these persons who are thus skeptical, when brought into contact with the work of a well-conducted institution, lose their disbelief and be- come warm supporters of the methods employed. Their cure makes them so, for how could they be otherwise when they have actually become partakers in the enjoy- ment of that for which they have so long searched ? There is much truth in the statement that stammer- ing is a lack of confidence. I believe it is, and also that many persons stammer in their every-day actions with- out ever speaking a word. Stammering has sometimes presented itself to me in these words : " I don't know whether I can or not ; I don't believe I can." The majority of my readers are persons who stam- mer. Have you ever felt that sensation of doubt ? Is not your first impression an impression of doubt, when approaching a word difficult of utterance ? Is not the second impression one of disbelief ? You say " yes." What is the result? Your answer is, "failure." Thas many persons stammer without even uttering a word. They doubt their own ability to perform certain acts. "They don't know whether they can or not; they don't believe they can." They halt, hesitate, stumble, in fact, they stammer, and even though it be by act alone, without the sound of vocal utterance, neverthe- — 123 — THE ORIGIN AND TREATMENT OF STAMMERING less it is characteristic of stammering, which in truth it really is. When, therefore, it is shown that stammer- ing is in form only a " lack of confidence," is it not a reasonable argument that the degree of success under treatment is always in ratio to the confidence of the pupil ? Is not confidence that element which we are trying to establish? How, then, can we establish a cure unless we can establish a confidence? The fact of the matter is, the cure consists largely of confidence, even as the defect is largely a lack of confidence. Take my advice, then : when you enter an institution have confidence in the instruction. Do not go in on the belief that every man is a rogue until you prove him honest, but in considering your cure beheve in your treatment that every man is honest until you prove him a rogue. This latter I confess is not a good policy to pursue in all things, but when the matter of establishing a cure for stammering is thus dependent upon the estab- lishing of confidence, it is well to believe from the be- ginning. I refer in this matter entirely to the pupil's conduct and belief after arriving at the institution. Be- fore entering such an institution, " make sure you are right and then go ahead." By this I mean take every precaution to thoroughly investigate its merits. If it bears favorable investigation and you are willing to " make the experiment," cast aside any disbelief which you may have previously entertained and abandon every doubt before enrolHng yourself as a pupil. Stake everything in belief and have confidence in your cure to the uttermost degree. This will insure a cure in any case of stammering, it matters not how severe the — 124 — THE ORIGIN AND TREATMENT OF STAMMERING case may be, providing the pupil is willing to obey in- structions. Much of course depends upon the instruc- tion. I refer only to such instruction as one would expect to find in any well-conducted and well-regulated institution for the cure of stammering. The time was when such institutions did not exist, but with the advancement of science new ideas have been developed along this line, from which have evolved practical methods for the cure of stammering. To enumerate the many different methods that have been practiced for the cure of stammering within the past century, giving a description of each, would fill an entire book, and could prove of little benefit, if any, to the reader. In truth, I believe it would prove harmful, as much time at earlier periods was uselessly spent in vain efforts to obtain radical results. Only within the past few years have practical methods of cure been in use — the result of modern thought, investiga- tion, and invention. In fact, as recently as 1852, methods of surgery were largely practiced for the cure of stammering, and with harmful results, as is shown by the following extract, taken from *' Stammering : Its Effects, Causes, and Remedies," by C. P. Bronson, M. D. Dr. Bronson was considered in his time an authority of unquestionable reputation, and concerning surgery as a remedy for stammering says : " I am also aware that some persons contend that stammering is caused by malformation of the vocal or- gans, which either produce or modify sound. But this opinion is incorrect, as is evident from the fact that it is caused by a disease which induces this impediment of — 135 — THE ORIGIN AND TREAl^MENT OF STAMMERING Speech. In consequence of this false notion, some grave professors of medicine and eminent surgeons have un- dertaken to cure stammering by operations, a few of which I witnessed some years ago in the medical de- partment of the New York University. Being person- ally interested in the subject, I took much pains to see individuals who had been operated upon as they came out of that college. I inquired of them whether they were cured. Their words and actions invariably replied in the negative. The operation I would observe," con- tinues Dr. Bronson, " was merely piercing the tongue transversely or cornerwise from about one-fourth of its corner side to-its right upper side." " In the name of common sense," says the Doctor, *' what has such an operation on a modifier of sounds to do with the organs that produce the sound ? " Many such nonsensical ideas prevailed among early investigators, the results of which served only to dis- hearten the stammerer. Several deaths were reported from hemorrhage. Stammerers were mutilated and cut to pieces in every imaginable way. Tongues were cut, tonsils removed, needles were inserted into and passed through the base of the tongue, sharp-pointed instru- ments forced into the vocal cavities, gargles of various kinds used to allay the irritation, and powders adminis- tered to the patient with the hope of benefiting him. One writer says : " My attention was called to an advertisement which proposed to cure stammering in various ways. One man advertised to cure by a surgi- cal operation, which he said could be performed in the twinkling of an eye, and the stammerer was forever — 126 — THE ORIGIN AND TREATMENT OF STAMMERING cured. I called on the performer (who dubbed himself Doctor), but without the least faith imaginable. In the center of his office stood a round table, on which was spread in beautiful confusion a quantity of surgical instruments such as dentists use. I made some in- quiries as to his mode of operation, price, etc., but with what little knowledge I then possessed of the structure of the human system I was confident that his apparatus was all a humbug, and not willing to be * fleeced ' for the ninety-ninth time, I retired with his angry words ringing in my ears." Such was the condition of things up until as late a period as 1850. Earlier than that time matters were even much worse, as is shown by the unbalanced theo- ries of authors who unhesitatingly put their views into print. As already mentioned, it could only serve as pro- ductive of evil that I should discuss further or enlarge upon their worthless methods, nearly all of which have since been abandoned. Better that I should tell my reader what I consider to-day the best means of treatment, and bury these old, worn-out, and threadbare ideas in the grave of the past, where they so fittingly belong. The use of a surgeon's knife to effect a cure is not required in one case of stammering in a thousand. Only where malformation of the organs appear is it necessary to perform a surgical operation, and of such cases during my entire acquaintance with stammerers I have known only one. This single case was a complicated one in many respects, and it may be a relief to add that stam- — 127 — THE ORIGIN AND TREATMENT OF STAMMERING mering was not due even in this instance to the malform- ation. It was necessary, however, in order to correct the articulation of the sufferer that an operation should be performed. As a matter of fact, his stammering habit was entirely cured before the operation was commenced, thus conclusively showing that there was no relation be- tween his stammering and the abnormality of his tongue. It simply happened that in addition to stammering he had unfortunately been born with a peculiarity which is some- times manifest in persons not addicted to stammering. Had he never stammered the operation would have been necessary just the same, in order to establish perfect artic- ulation. Malformation of the speaking organs among stammerers is very rare, and not at all more common than among persons not thus afflicted. Among letters received from many thousands of per- sons addicted to stammering, and from my personal acquaintance with a great number, I have recollection of but few instances where any defect other than that of stammering was manifested in the patient. As, has been demonstrated again and again, surgery can only prove harmful where it is not necessary, and I know of no better illustration of the truth of this statement than in cases of stammering. The less the stammerer has to do with the knife of the surgeon the better for him in nine hundred and ninety-nine cases out of every thou- sand. I have always maintained and still believe that medi- cine is sometimes necessary in cases of stammering, even as I believe its use is necessary by many persons who do not stammer. I will go further than this, and say that it — 128 — THE ORIGIN AND TREATMENT OF STAMMERING is particularly beneficial as an auxiliary in some peculiar cases of the intermittent class, where the physical condi- tion of the sufferer has much to do with his ease in talk- ing. Stammerers who suffer from exhausted vitality or who have weakened energy, in applying themselves may oftentimes profit by the advice and attention of a good family physician. Any reputable doctor will tell you, however, that the less medicine you take the better for you. A judicious amount of exercise, plenty of sleep and rest, and good, wholesome diet are in the majority of instances much better than medicine. Often a mild tonic is necessary or even a physic to arouse the Hver ; but other than this, unless there is some chronic ailment, leave medicine alone. All good methods for the cure of stammering should have incorporated into their regimen a graded system of physical exercises. Graded, for the reason that what might prove beneficial to one patient would be harmful for another. From the fact that mental energy and will- power, upon which good talking largely depends, are largely induced and augmented by judicious exercise, one who stammers should take every opportunity that presents itself to put himself in the **pink" of condition physically. That physical exercise is beneficial in the treatment of stammering no recognized authority disputes, exer- cises to develop the torso, and for the development of the muscles of the neck, being especially productive of good. Physical exercise in a general way, such as one will re- ceive in the ordinary first-class gymnasium where the regimen is directed by a well-informed instructor must 9 —129 — THE ORIGIN AND TREATMENT OF STAMMERING also serve to lessen the severity of the stammerer's dif- ficulty. The reason for this is not at first apparent, but when one stops to consider that such exercises serve to subjugate the muscles to the power and influence of the mind the object is readily made clear. Who will say that by disciplining the muscles of the body to obey the commands of the will we have not gained the first step in harmonizing this inharmonious action? I have always maintained that breathing exercises for the de- velopment of the organs of respiration were highly bene- ficial to the stammerer as a means in overcoming his impediment, but have never advocated their use wholly as a means of physical development. My purpose in using breathing exercises is not wholly because they strengthen the organs of respiration, nor because they serve to increase the capacity of the lungs. Stammering is not due to incorrect breathing habits, which latter are generally the result of stammering. Neither is stammering due to an undercapacity of the lungs. Why, then, use breathing exercises in overcoming the defect? My answer is, "■ for the same reason that I would use physical exercises, for the same reason that I would use vocal exercises." Physical exercises are well adapted to improve the general health and physique of the sufferer ; breathing exercises are beneficial to aid in this physical development, and vocal exercises serve to mellow and strengthen the voice, which is good even to persons not afflicted with stammering. These exer- cises, however, as used in connection with a treatment for the cure of stammering should, while intended as an — 130 — THE ORIGIN AND TREATMENT OF STAMMERING auxiliary to the general health of the sufferer, be given for the purpose of mental discipline. I will endeavor to make myself clear in this state- ment by saying that the defect of the stammerer is in the mind,* not in a weakened voice, not in general physical weakness nor in incorrect habits of breathing. These latter are all the results of stammering and are generally associated with the defect, and often serve to aggravate it, but should never be attributed as a cause. Stammering is manifested in a lack of ready and harmonious response of the muscles of the body to the commands of the will. It is therefore by making the muscles obey the will that we principally succeed in overcoming the defect. To do this we must give the mind absolute control over every muscle of the body, and whether it be a muscle concerned in the production of speech or not it must be disciplined to obey. If we would control the unruly muscles we must obtain a more ready response from each and every one. We must be able to control them separately, in pairs, and together. Desire must become a command, and command, law. To accomplish this we must summon to our aid every exercise where mind and muscle may act one upon the other, and by means of a process of educational training we strengthen both, teach the latter to act in conformity with the commands of the former harmoni- ously and with precision. As an illustration let us for example execute costal breathing. We place the flat portion of the hands upon * See footnote page 27. THE ORIGIN AND TREATMENT OF STAMMERING the sides just beneath the arm pits, and by inhaling through the nostrils we inflate the lungs in such a man- ner as to extend the muscles of the sides while the body assumes a flattened position from front to back. In per- forming this exercise we direct the mind to action and by exercising the will and centralizing it for a few moments we force into quick and ready obedience those muscles which, as the result of stammering, oftentimes refuse at first to obey. Other forms of breathing are similarly exe- cuted, until finally the mind becomes all powerful in command. Physical exercises serve much the same pur- pose. The gymnast will tell you physical exercises, if practiced regularly, give the mind control of the body. This is seen in the great muscular feats performed by such men as Sandow, who by the command of his will alone could knot every cord and muscle of his body. Many can move the muscles of their scalp without a per- ceptible movement from any other portion of their entire body. The same is true of the muscles of their chest, back, legs, and arms, over all of which they have absolute control either individually or collectively. And all this control is but the result of continually practiced mental discipHnary exercise, the organs of the body being dis- ciplined and educated to obey the dictates of the mind. The same theory that applies to breathing and physical exercises is also true in vocal exercise. Much as has been said by others about the advantages of breathing, vocal and physical exercises for the treatment of stam- mering, I have never heard it advocated nor have I ever read that they were intended for any other purpose than for the mere object of simple corrections in incorrect — 132 — THE ORIGIN AND TREATMENT OF STAMMERING breathing habits, for the development of the voice or for strengthening a weakened organism. I have always been aware they served for all these purposes and that they are highly beneficial, but their better purpose has never been outlined to me. It has come to me through real experience in the treatment of hundreds of cases, that the object of such exercises as I have mentioned when used in connection with methods for the cure of stammering is for a better purpose than is generally believed — that of disciplining the muscles of the body to obey the com- mands and dictates of the mind. — 133 THE MECHANISM OF SPEECH * It has been said that stammering is caused by a want of due control of the mind over the vocal organs, and as the brain is the seat of the mind let us consider its physiological construction and functions. The brain is divided into two parts, the cerebrum and the cerebellum. The cerebrum fills the front and upper part of the skull and comprises about seven- eighths of the entire weight of the brain. In appearance it resembles an English walnut. It is divided into two parts, the same as the meat of a walnut or hickory nut, and like them is curiously wrinkled and folded with convolutions. The greater the number and deepness of the convolutions the greater the mental power. The cerebellum Hes below the cerebrum and is in the back part of the head. Its structure is similar to that of the brain proper, but instead of convolutions it has parallel ridges, which give it a peculiar appearance, called the arborvitae or tree of Hfe. The cerebrum is the seat of the mind. It is the function which the cerebrum performs that distinguishes man from all other animals and it is through the action of the cerebrum that he becomes a conscious, intelligent, * Extract from the Phono-Meter, a monthly paper exclusively for per- sons who stammer ; edited and published by Geo. Andrew I^ewis.— See last page. — 134 — THE ORIGIN AND TREATMENT OF STAMMERING and responsible being. The cerebrum is the center of thought. Persons in whom it is seriously injured often become unable to converse intelligently, both from in- ability to remember words and from loss of power to articulate them. The cerebellum, lying between the base of the cere- brum and the upper part of the spinal cord or an expansion of the cord called the medulla oblongata, is the center for the control of the voluntary muscles. There are two kinds of muscles, the voluntary and the involuntary. The voluntary muscles are those con- trolled by the will. If we see a dime, the mind sends a message over the motory nerve to the controlling muscles of the arm and fingers to act, to get into motion, to pick it up, and the muscles having always been accus- tomed to do the mind's bidding without any doubting, work harmoniously. Therefore the muscles of the arm and fingers and all such muscles are voluntary because they are controlled by the will. Without any message from the mind, our hearts beat day in and day out, year in and year out. This throbbing of the heart is beyond the control of the will and hence the heart is the best example of an involuntary muscle. However, as we can wink when we wish to and we can't help but wink ever so often, the muscles of the eyelid are both voluntary and involuntary. Of all cases the inherited case is the worst. In the inherited case, there is an inherited abnormal condition from the very first, and if the child is given the proper instruction in articulation, vocalization, and breathing, and is taught to have confidence in its ability to talk, -135- THE ORIGIN AND TREATMENT OF STAMMERING and knows just how to speak, then this knowledge be- comes a power, and it can converse without any fear, because it knows just how to make the vocal organs obey the will. But if its case be neglected its life be- comes one of constant fear and embarrassment. If a kind friend, a loving teacher, or a fond parent does not give the needed instruction and leaves the child in fear and trembling to carve out its own self-cure, it may yield to the taunts of its thoughtless schoolmates or playmates and slowly lose what little will power it may have, and gradually get worse and worse. The reason parents and teachers do not give instruc- tion to such children is because they do not know how, nor do they know what kind of instruction is needed, and many times think the child will outgrow it. They never outgrow it, however. But you say you know of persons who stammered when in youth who do not after coming to maturity. Did they not outgrow it? No. After they became old enough to think, they began to study their case, and by study and practice they effected a self-cure, or greatly modified the impediment. Voice is sound produced by the vibrations of the vocal cords in the larynx. At the top of the windpipe or trachea, leading from the lungs, is an enlargement, commonly called ''Adam's apple," but really the larynx, or voice box. If a small mirror, attached to a long handle, be placed back into the upper part of the throat (the handle near the mirror must be at an angle of 45 degrees, so that we may look " around the corner," so to speak) behind the tongue we may see the image as drawn in Fig. i. --136-- FIG 1 IMAGE OF VOCAL APPARATUS, AS SEEN IN A MIRROR HELD FAR BACK IN THE MOUTH —From Dr. Cohen's " Health Primer." By placing a little mirror into the back part of the open mouth while the latter is well illuminated, we are able to see an image of the interior of the larynx, and observe in greater part the mechanism of the vocal bands in the acts of respiration and production of voice. In this way the register of the voice, as it is termed, can be studied optically, and its transition points be noted bv inspection. The credit of the first successful demonstra- tion of this kind belongs to Signor Manuel Garcia, of lyondon, a teacher of vocal music, who in 1854 devised the i)lan in the interest of vocal art. The manipulation is well known to physicians, who frequently employ it for observing the conditions of the parts in disease.— CK\ ,~ : -. ■> -riSS|*j3r«iCii^r:; ;^^-: i;-:-,-igi5; Hsjj'^tg;; -iJiSff^-lCi? "-^^- -^^^^-^^^-'-^^^Sffi C:?^ -liA' J^^Ml^'jixH '.•.:/,;;ts-c;x,A~j- IpIlM^ :^i||S^l'!i^pili8fe — ^ m:':^:;^m m^^ ISii'^pIfS'KrHii m. ifliKni;